Mill Creek Family Practice PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MILL CREEK FAMILY PRACTICE PLLC

Practice address

1025 153Rd St SE
Suite 200
Mill Creek, WA 98012-4051

Phone

(425) 338-4000

Fax

(425) 745-6158

NPI assigned

Feb 9, 2007

Last updated

Feb 13, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark T Anderson, MDNPI 1316961659

Title

Physician

Phone

(425) 338-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark T Anderson, MD

  • Family Medicine Physician
  • Mill Creek, WA
  • NPI 1316961659
  Authorized official Same address or phone

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1598806770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 153RD ST SE",
            "address_2": "SUITE 200",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124051",
            "telephone_number": "425-338-4000",
            "fax_number": "425-745-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 153RD ST SE",
            "address_2": "SUITE 200",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124051",
            "telephone_number": "425-338-4000",
            "fax_number": "425-745-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL CREEK FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "425-338-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7098643",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Louise Meyers
• Mill Creek Chiropractic Clinic, PS
• Mill Creek Eye and Contact Lens Clinic, Inc. (Mill Creek Vision)
• Mill Creek Family Eyewear
• Mill Creek Family Medicine, Inc
• Mill Creek Family Services, PLLC
• Mill Creek Foot & Ankle Clinic P.C.
• Mill Creek General Dentistry
• Mill Creek Implants & Periodontics
• Mill Creek Pharmacy Inc (Mill Creek Pharmacy)

• Family Medicine Physician in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.