4TH STREET MEDICAL CARE PLLC (NPI# 1659559409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659559409 |
| Entity Type | Organization |
| Organization Name | 4TH STREET MEDICAL CARE PLLC |
| Practice Address |
1602 4th St Marysville WA 98270-5014 |
| Practice Telephone | 3606594141 |
| Practice Fax Number | 3606591712 |
| Mailing Telephone | 3606594141 |
| Mailing Fax Number | 3606591712 |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2014-12-08 |
| Authorized Official Name | DR. SANTOSA HO (OWNER) |
| Authorized Official Telephone | 3606594141 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
602329907 | WA | Ambulatory Health Care Facilities |
| Street Address |
1602 4TH ST |
| City | MARYSVILLE |
| State | WA |
| Zip Code | 98270-5014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730706631 | Amy Jean Tuengel | Massage Therapist | 4731 61st Ne, Marysville, WA 98270 | 2020-06-26 |
| 1821569534 | Andrew M Reid | Physical Therapist | Marysville Physical Therapy, 919 State Avenue Suite 101, Marysville, WA 98270 | 2018-12-07 |
| 1861989162 | Jenna Celine Schmidt | Student in an Organized Health Care Education/Training Program | Seamar Marysville Family Medicine Residency Program, 9710 State Ave, Marysville, WA 98270 | 2018-04-23 |
| 1497103162 | Kyoung Craddock | Registered Nurse | 5722 65th St Ne, Marysville, WA 98270 | 2016-06-02 |
| 1235553348 | Marysville School District | Speech-Language Pathologist | 4220 80th Street Ne, Marysville School District, Marysville, WA 98270 | 2014-02-10 |
| 1386085694 | Malgorzata Cassidy | Counselor | 4308 76th. St. Ne, Marysville, WA 98270 | 2013-07-15 |
| 1972852374 | Suzanne Leboeuf | Counselor | 1227 2nd St., Marysville, WA 98270 | 2012-08-31 |
| 1508121161 | Tricia Nicole Davis | Pharmacy Technician | 6602 74th St Ne, Marysville, WA 98270 | 2012-07-10 |
| 1962774216 | Lynae Marie Swinheart | Community/Behavioral Health | 6418 66th Pl Ne, Marysville, WA 98270 | 2012-02-02 |
| 1598042459 | Jamie Rae Isaacson | Speech-Language Pathologist | 1820 Grove St., Marysville, WA 98270 | 2011-11-07 |
| Find all providers in zip 98270 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1699114108 | Lower Lights Christian Health Center, Inc | Clinic/Center | 773 S Walnut St, Marysville, OH 43040-1643 | 2013-06-18 |
| 1174884696 | Thomas Neuschatz, M.d., Inc. | Clinic/Center | 118 C St, Marysville, CA 95901-6016 | 2012-05-31 |
| 1356645014 | Whole Health Medical Group Ohio, PC | Clinic/Center | 14210 Scottslawn Rd, Marysville, OH 43041-0001 | 2011-01-10 |
| 1629211529 | Whole Health Medical Group Ohio Professional Corporation | Clinic/Center | 14210 Scottslawn Rd, Marysville, OH 43041-0001 | 2009-04-08 |
| 1558543934 | Community Memorial Healthcare, Inc. | Clinic/Center | 708 N 18th St, Marysville, KS 66508-1338 | 2007-11-28 |
| 1780806869 | Northwest Center for Optimal Health Inc | Clinic/Center | 316 State Ave, Marysville, WA 98270-5028 | 2007-05-02 |
| 1295749067 | Community Memorial Healthcare, Inc. | Clinic/Center | 1902 May St, Marysville, KS 66508-1200 | 2006-07-28 |
| Find all providers in MARYSVILLE | ||||
| City | MARYSVILLE |
| Zip Code | 98270 |
Please comment or provide details below to improve the information on 4TH STREET MEDICAL CARE PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.