| Collaborative Care PLLC | |
|
1534 Ne 100th St Seattle WA 98125-7662 | |
| (206) 498-0453 | |
| Not Available |
| Full Name | Collaborative Care PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1534 Ne 100th St, Seattle, Washington |
| Authorized Official Name and Position | Andrew Grossman (OWNER) |
| Authorized Official Contact | 2064980453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Collaborative Care PLLC 1534 Ne 100th St Seattle WA 98125-7662 Ph: (206) 498-0453 | Collaborative Care PLLC 1534 Ne 100th St Seattle WA 98125-7662 Ph: (206) 498-0453 |
| NPI Number | 1184419376 |
|---|---|
| Provider Enumeration Date | 04/10/2025 |
| Last Update Date | 05/14/2025 |
| Certification Date | 05/14/2025 |
| Medicare PECOS PAC ID | 7315421955 |
|---|---|
| Medicare Enrollment ID | O20260320002227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184419376 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Andrew T Grossman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134483266 PECOS PAC ID: 4789833484 Enrollment ID: I20121011000903 |
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