Miniclinic, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

AP60327305 Issued in WA

Legal business name

MINICLINIC, LLC

Practice address

22007 Meridian Ave E Ste C
Graham, WA 98338

Phone

(253) 780-4930

Fax

(253) 375-6842

NPI assigned

Jan 30, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peggy Jan Briggs, ARNP

Title

Owner

Phone

(253) 780-4930

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531094400000",
    "number": "1518404425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22007 MERIDIAN AVE E STE C",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983388412",
            "telephone_number": "253-380-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22007 MERIDIAN AVE E STE C",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "98338",
            "telephone_number": "253-780-4930",
            "fax_number": "253-375-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINICLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2018-07-09",
        "status": "A",
        "authorized_official_last_name": "BRIGGS",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-780-4930",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "AP60327305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael David McMullin, LMP
• Natalia Regina Mejia
• Aracely Mendez, CBT/RBT
• Eric Karl Miller, M.A.
• Heather Mills, RN, IBCLC
• Leilani Patricia Morales
• Yahaira Maria Morales
• Sivan N Mudaliar, DPT
• Anthony Mueller
• Paul T Mukai, PT

• Primary Care Clinic/Center in Graham, WA
• Providers in Graham, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.