Provider Demographics
NPI:1952553919
Name:QUICK CARE CLINIC PLLC
Entity Type:Organization
Organization Name:QUICK CARE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:MARGOT
Authorized Official - Last Name:CHOFFEL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-856-5900
Mailing Address - Street 1:204 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-1553
Mailing Address - Country:US
Mailing Address - Phone:360-856-5900
Mailing Address - Fax:360-899-5916
Practice Address - Street 1:204 W STATE ST
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-1553
Practice Address - Country:US
Practice Address - Phone:360-856-5900
Practice Address - Fax:360-899-5916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6026297777261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9642059Medicaid