Provider Demographics
NPI:1477594356
Name:PACMED CLINICS
Entity type:Organization
Organization Name:PACMED CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECREATRY FOR ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:425-358-9786
Mailing Address - Street 1:19401 40TH AVE W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4612
Mailing Address - Country:US
Mailing Address - Phone:425-744-7153
Mailing Address - Fax:
Practice Address - Street 1:19401 40TH AVE W
Practice Address - Street 2:SUITE 100
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4612
Practice Address - Country:US
Practice Address - Phone:425-744-7153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB34789Medicare ID - Type Unspecified