| Fader Primary Care, Pllc | |
|
2513 152nd Ave Ne Redmond WA 98052-5574 | |
| (425) 301-8190 | |
| Not Available |
| Full Name | Fader Primary Care, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2513 152nd Ave Ne, Redmond, Washington |
| Authorized Official Name and Position | Seth Fader (MEMBER/OWNER) |
| Authorized Official Contact | 4253018190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fader Primary Care, Pllc Po Box 1281 Bellevue WA 98009-1281 Ph: (425) 301-8190 | Fader Primary Care, Pllc 2513 152nd Ave Ne Redmond WA 98052-5574 Ph: (425) 301-8190 |
| NPI Number | 1700474749 |
|---|---|
| Provider Enumeration Date | 01/05/2021 |
| Last Update Date | 01/05/2021 |
| Medicare PECOS PAC ID | 3274949961 |
|---|---|
| Medicare Enrollment ID | O20210303002667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700474749 | NPI | - | NPPES |
| 604544384 | Other | WA | STATE UBI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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