Basic Information
| Provider Information | |||||||||
| NPI: | 1760041412 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY CARE NETWORK, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 709 W. ORCHARD DR. | ||||||||
| Address2: | STE. 4 | ||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603188800 | ||||||||
| FaxNumber: | 2603181085 | ||||||||
| Practice Location | |||||||||
| Address1: | 1610 GROVER ST. | ||||||||
| Address2: | STE. D-1 | ||||||||
| City: | LYNDEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603541333 | ||||||||
| FaxNumber: | 3603545399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2019 | ||||||||
| LastUpdateDate: | 06/06/2019 | ||||||||
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| AuthorizedOfficialLastName: | ANDERSON | ||||||||
| AuthorizedOfficialFirstName: | RODNEY | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT AND PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 3603188800 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | FAMILY CARE NETWORK, PLLC | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.