Provider Demographics
NPI:1992764989
Name:STATCARE INC
Entity type:Organization
Organization Name:STATCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:DILLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-385-2634
Mailing Address - Street 1:10333 19TH AVE SE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4259
Mailing Address - Country:US
Mailing Address - Phone:425-385-2634
Mailing Address - Fax:425-385-2635
Practice Address - Street 1:10333 19TH AVE SE
Practice Address - Street 2:SUITE 103
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-4259
Practice Address - Country:US
Practice Address - Phone:425-385-2634
Practice Address - Fax:425-385-2635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00017867261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA22553Medicare UPIN
WAG8856991Medicare PIN