| NPI | 1902935711 |
|---|---|
| Former Legal Business Name | ELLIOTT BAY MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JULIE MARIA SMITH Clinic Manager 206-838-6856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: WA 602476731) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2015-02-06 |