Basic Information
| Provider Information | |||||||||
| NPI: | 1477189249 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY CARE NETWORK PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 709 W ORCHARD DR | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603188800 | ||||||||
| FaxNumber: | 3603181085 | ||||||||
| Practice Location | |||||||||
| Address1: | 8097 HARBORVIEW RD | ||||||||
| Address2: | |||||||||
| City: | BLAINE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603715855 | ||||||||
| FaxNumber: | 3603715857 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2020 | ||||||||
| LastUpdateDate: | 03/12/2020 | ||||||||
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| AuthorizedOfficialLastName: | ANDERSON | ||||||||
| AuthorizedOfficialFirstName: | RODNEY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3603188800 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | FAMILY CARE NETWORK PLLC | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | N | Laboratories | Clinical Medical Laboratory | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.