| Eastside Medical Group, Llc | |
|
1301 4th Ave Nw Issaquah WA 98027-9371 | |
| (425) 270-3713 | |
| (425) 295-7557 |
| Full Name | Eastside Medical Group, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 4th Ave Nw, Issaquah, Washington |
| Authorized Official Name and Position | Robert Howie (TREASURER) |
| Authorized Official Contact | 4258379720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Medical Group, Llc 1301 4th Ave Nw Suite 201 Issaquah WA 98027-9371 Ph: (425) 270-3713 | Eastside Medical Group, Llc 1301 4th Ave Nw Issaquah WA 98027-9371 Ph: (425) 270-3713 |
| NPI Number | 1750709358 |
|---|---|
| Provider Enumeration Date | 04/01/2014 |
| Last Update Date | 01/18/2017 |
| Medicare PECOS PAC ID | 3870726185 |
|---|---|
| Medicare Enrollment ID | O20140512000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750709358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (* (Not Available)) | Primary |
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