Basic Information
Provider Information
NPI: 1467493346
EntityType: 2
ReplacementNPI:  
OrganizationName: PACMED CLINICS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: PACIFIC MEDICAL CENTERS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10416 5TH AVE NE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981257402
CountryCode: US
TelephoneNumber: 2065176700
FaxNumber:  
Practice Location
Address1: 10416 5TH AVE NE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981257402
CountryCode: US
TelephoneNumber: 2065176700
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/09/2006
LastUpdateDate: 10/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DABHI
AuthorizedOfficialFirstName: VIKRAMSINH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF MEDICAL OFFICER
AuthorizedOfficialTelephone: 2066214618
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM1300X  Y Ambulatory Health Care FacilitiesClinic/CenterMulti-Specialty

No ID Information.


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