Provider Demographics
NPI:1821870601
Name:ALPHA MD LLC
Entity Type:Organization
Organization Name:ALPHA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOAMES
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:206-755-6846
Mailing Address - Street 1:11477 NW ADMIRAL PL
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-4503
Mailing Address - Country:US
Mailing Address - Phone:833-432-5633
Mailing Address - Fax:
Practice Address - Street 1:11477 NW ADMIRAL PL
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-4503
Practice Address - Country:US
Practice Address - Phone:833-432-5633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty