Maranatha Medical Clinic Inc P S

LBN: Maranatha Medical Clinic Inc P S
Maranatha Medical Clinic Inc P S is an health care organization with primary practice located at 17900 Talbot Rd S #101, Renton WA 98055-8212. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Maranatha Medical Clinic Inc P S can be contacted via phone (425) 235-9614, or through Grav Es, Dan L via phone (425) 235-9614.

Contact Information

Primary practice address
17900 Talbot Rd S #101 Renton WA 98055-8212
Phone: (425) 235-9614
Fax: (425) 235-1060
Website:
Map and Directions
Authorized official contact:
Name: Grav Es, Dan L Doctor of Medicine (MD)
Phone: (425) 235-9614

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 17917 Washington

Profile Details

NPI number 1205164639
LBN Legal business name Maranatha Medical Clinic Inc P S
DBA Doing business as
Authorized official Grav Es, Dan L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 23rd, 2009
Last updated Sep 11th, 2017 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1205164639 NPPES
Washington MEDICAID 1620509

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