| Sweet Medical Group, Pllc | |
|
4524 Intelco Loop Se Lacey WA 98503-5941 | |
| (360) 491-9890 | |
| (360) 667-5135 |
| Full Name | Sweet Medical Group, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4524 Intelco Loop Se, Lacey, Washington |
| Authorized Official Name and Position | Bethany Sweet (MD/OWNER) |
| Authorized Official Contact | 3604919890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sweet Medical Group, Pllc Po Box 944 East Olympia WA 98540-0944 Ph: (360) 491-9890 | Sweet Medical Group, Pllc 4524 Intelco Loop Se Lacey WA 98503-5941 Ph: (360) 491-9890 |
| NPI Number | 1104340405 |
|---|---|
| Provider Enumeration Date | 07/28/2017 |
| Last Update Date | 06/15/2022 |
| Medicare PECOS PAC ID | 9234403551 |
|---|---|
| Medicare Enrollment ID | O20170925001763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104340405 | NPI | - | NPPES |
| 1821240904 | Medicaid | WA | |
| G8902804 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD60155686 (Washington) | Primary |
| Provider Name | Bethany M Sweet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821240904 PECOS PAC ID: 3173792983 Enrollment ID: I20110812000312 |
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