Longevity Medical Clinic

LBN: Longevity Medical Clinic
Longevity Medical Clinic is an health care organization with primary practice located at 9757 Ne Juanita Dr Suite 200, Kirkland WA 98034-4299. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Longevity Medical Clinic can be contacted via phone (425) 576-9272, or through Mixon, Jerry N via phone (425) 576-9272.

Contact Information

Primary practice address
9757 Ne Juanita Dr Suite 200 Kirkland WA 98034-4299
Phone: (425) 576-9272
Fax: (425) 576-0894
Website:
Map and Directions
Authorized official contact:
Name: Mixon, Jerry N Doctor of Medicine (MD)
Phone: (425) 576-9272

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD23643 Washington

Profile Details

NPI number 1023231172
LBN Legal business name Longevity Medical Clinic
DBA Doing business as
Authorized official Mixon, Jerry N Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 10th, 2007
Last updated Jun 21st, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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