Basic Information
| Provider Information | |||||||||
| NPI: | 1467194324 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY CARE NETWORK PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 709 W ORCHARD DR STE 4 | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982251766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603188800 | ||||||||
| FaxNumber: | 3607143152 | ||||||||
| Practice Location | |||||||||
| Address1: | 1310 10TH ST STE 104 | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982257026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605940592 | ||||||||
| FaxNumber: | 3605262165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2022 | ||||||||
| LastUpdateDate: | 04/11/2022 | ||||||||
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| AuthorizedOfficialLastName: | ARNZEN | ||||||||
| AuthorizedOfficialFirstName: | KEITH | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 3603188800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | FAMILY CARE NETWORK, PLLC | ||||||||
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| NPICertificationDate: | 04/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.