Provider Demographics
NPI:1194052506
Name:ACCESS HEALTHCARE, PLLC
Entity type:Organization
Organization Name:ACCESS HEALTHCARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-288-8882
Mailing Address - Street 1:1402 LAKE TAPPS PARKWAY EAST
Mailing Address - Street 2:SUITE F 106
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8157
Mailing Address - Country:US
Mailing Address - Phone:253-288-8882
Mailing Address - Fax:
Practice Address - Street 1:1402 LAKE TAPPS PARKWAY EAST
Practice Address - Street 2:SUITE F 106
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8157
Practice Address - Country:US
Practice Address - Phone:253-288-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7123334Medicaid
WA8803311Medicare PIN