| At Family Practice Group Ps | |
|
24604 104th Ave Se Ste 201 Kent WA 98030-5385 | |
| (253) 854-9799 | |
| Not Available |
| Full Name | At Family Practice Group Ps |
|---|---|
| Speciality | Family Medicine |
| Location | 24604 104th Ave Se Ste 201, Kent, Washington |
| Authorized Official Name and Position | Amandeep Mann (PROVIDER) |
| Authorized Official Contact | 2533946574 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| At Family Practice Group Ps 24604 104th Ave Se Ste 201 Kent WA 98030-5385 Ph: () - | At Family Practice Group Ps 24604 104th Ave Se Ste 201 Kent WA 98030-5385 Ph: (253) 854-9799 |
| NPI Number | 1346938685 |
|---|---|
| Provider Enumeration Date | 04/25/2023 |
| Last Update Date | 05/16/2023 |
| Medicare PECOS PAC ID | 2163889502 |
|---|---|
| Medicare Enrollment ID | O20230531000887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346938685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amandeep K Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669914354 PECOS PAC ID: 6103195789 Enrollment ID: I20170713001966 |
| Provider Name | Amandeep Debessay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699540211 PECOS PAC ID: 4688017189 Enrollment ID: I20240212004229 |
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