Provider Demographics
NPI:1891518775
Name:PENDLETON FAMILY HEALTH PLLC
Entity type:Organization
Organization Name:PENDLETON FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:PENDLETON
Authorized Official - Suffix:II
Authorized Official - Credentials:ND
Authorized Official - Phone:206-790-8631
Mailing Address - Street 1:1306 MILL CREEK BLVD APT N201
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4023
Mailing Address - Country:US
Mailing Address - Phone:425-919-0856
Mailing Address - Fax:
Practice Address - Street 1:22833 BOTHELL EVERETT HWY STE 206
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9368
Practice Address - Country:US
Practice Address - Phone:425-919-0856
Practice Address - Fax:425-224-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2128520Medicaid