Provider Demographics
NPI:1700996055
Name:MONROE WOMENS CARE, PC
Entity Type:Organization
Organization Name:MONROE WOMENS CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-282-4180
Mailing Address - Street 1:14841 179TH AVE SE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1127
Mailing Address - Country:US
Mailing Address - Phone:360-794-1444
Mailing Address - Fax:360-805-3461
Practice Address - Street 1:14841 179TH AVE SE
Practice Address - Street 2:SUITE 310
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1127
Practice Address - Country:US
Practice Address - Phone:360-794-1444
Practice Address - Fax:360-805-3461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7104219Medicaid
WAGAB20193Medicare PIN