Provider Demographics
NPI:1831301563
Name:FAMILY CARE NETWORK PLLC
Entity Type:Organization
Organization Name:FAMILY CARE NETWORK PLLC
Other - Org Name:FERNDALE FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY CARE NETWORK PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:HIPSKIND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-318-9705
Mailing Address - Street 1:709 W ORCHARD DRIVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-0066
Mailing Address - Country:US
Mailing Address - Phone:360-318-9705
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:5580 NORDIC WAY
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248
Practice Address - Country:US
Practice Address - Phone:360-384-1511
Practice Address - Fax:360-384-5758
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY CARE NETWORK PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-04
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7591555Medicaid