Provider Demographics
NPI:1881769552
Name:WESTCARE CLINIC INC PS
Entity type:Organization
Organization Name:WESTCARE CLINIC INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HADUONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-386-4700
Mailing Address - Street 1:7602 BRIDGEPORT WAY W STE 4A
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2432
Mailing Address - Country:US
Mailing Address - Phone:360-357-9392
Mailing Address - Fax:360-528-3049
Practice Address - Street 1:4509 TALBOT RD S STE 201
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6294
Practice Address - Country:US
Practice Address - Phone:360-357-9392
Practice Address - Fax:360-528-3049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty