Valley Roots Family Care Pllc

LBN: Valley Roots Family Care Pllc
Valley Roots Family Care Pllc is an health care organization with primary practice located at 617 W. Division St. , Mount Vernon WA 98273. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Valley Roots Family Care Pllc can be contacted via phone (360) 428-1884, or through Thomas, Tara via phone (360) 428-1884.

Contact Information

Primary practice address
617 W. Division St. Mount Vernon WA 98273
Phone: (360) 428-1884
Fax: (360) 428-1889
Website:
Map and Directions
Authorized official contact:
Name: Thomas, Tara
Phone: (360) 428-1884

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00040349 Washington

Profile Details

NPI number 1144693250
LBN Legal business name Valley Roots Family Care Pllc
DBA Doing business as
Authorized official Thomas, Tara
Entity Organization
Organization subpart 1 No
Enumeration date Nov 11th, 2015
Last updated Dec 21st, 2021 - about 5 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 1144693250 NPPES
Washington Other 0220687 LABOR AND INDUSTRIES
Washington MEDICAID 2076241 LABOR AND INDUSTRIES
Washington MEDICAID 8457228 LABOR AND INDUSTRIES

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