Innovative Care Clinic

NPI #1346518925 in Mill Creek, Washington

Provider Information

NPI Number: 1346518925
Entity Type: Organization
Organization Name: Innovative Care Clinic
Primary Specialty: Specialist
Enumeration Date: Dec 9, 2011
Last Updated: Dec 9, 2011

Practice Location

Address: 1700 132ND ST SE
Address 2: SUITE L
City: Mill Creek
State: Washington
ZIP Code: 98012-5309
Phone: (425) 338-1555

Authorized Official

Name: MRS. FERNANDA VELDERRAIN
Title: OFFICE MANAGER
Phone: (425) 338-1555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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