Provider Demographics
NPI:1790913374
Name:NORTH CREEK MEDICINE INC PS
Entity Type:Organization
Organization Name:NORTH CREEK MEDICINE INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:SWYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-337-5100
Mailing Address - Street 1:210 128TH ST SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6338
Mailing Address - Country:US
Mailing Address - Phone:425-337-5100
Mailing Address - Fax:425-745-3933
Practice Address - Street 1:210 128TH ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6338
Practice Address - Country:US
Practice Address - Phone:425-337-5100
Practice Address - Fax:425-745-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA19726207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty