| Optum - La Conner Medical Center | |
|
528 Myrtle Street Laconner WA 98257 | |
| (360) 466-3136 | |
| Not Available |
| Full Name | Optum - La Conner Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 528 Myrtle Street, Laconner, Washington |
| Authorized Official Name and Position | George Go (BOARD PRESIDENT) |
| Authorized Official Contact | 4252590966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum - La Conner Medical Center Po Box 5127 Everett WA 98206-5127 Ph: (360) 466-3136 | Optum - La Conner Medical Center 528 Myrtle Street Laconner WA 98257 Ph: (360) 466-3136 |
| NPI Number | 1255950572 |
|---|---|
| Provider Enumeration Date | 04/16/2020 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255950572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Primary |
| 208000000X | Pediatrics | () | Secondary |
| 291U00000X | Clinical Medical Laboratory | () | Secondary |