Provider Demographics
NPI:1124631296
Name:DIRECT CARE CLINICS US PC
Entity type:Organization
Organization Name:DIRECT CARE CLINICS US PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DINO
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RAMZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-999-5138
Mailing Address - Street 1:2370 E 3RD LOOP STE 203
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-7725
Mailing Address - Country:US
Mailing Address - Phone:360-999-5138
Mailing Address - Fax:
Practice Address - Street 1:2370 E 3RD LOOP STE 203
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7725
Practice Address - Country:US
Practice Address - Phone:360-999-1538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIRECT CARE CLINICS US PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-28
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty