RANIER BEACH MEDICAL CLINIC – NPI #1053417675
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Health Care Provider Taxonomy Code for Clinic/Center

RANIER BEACH MEDICAL CLINIC is an AHC clinic located in SEATTLE, WA. NPPES has assigned the NPI number 1053417675 to RANIER BEACH MEDICAL CLINIC on September 15, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “RANIER BEACH MEDICAL CLINIC” is a dba name, the actual legal business name for this organization is PRUDENCIO G TIBLE MD PC. The primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for RANIER BEACH MEDICAL CLINIC below.

NPI Profile for
PRUDENCIO G TIBLE MD PC

NPI Number
1053417675
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRUDENCIO G TIBLE MD PC
Doing Business As (dba): RANIER BEACH MEDICAL CLINIC
Primary location
5023 S BARTON PLACE
SEATTLE, WA 98118
Phone: (206) 725-8043 Fax: (206) 760-1359
Mailing address
PO BOX 18936
SEATTLE, WA 98118
Phone: (206) 725-8043 Fax: (206) 760-1359
Organization Subpart
No
Authorized Official
PRUDENCIO TIBLE
PRESIDENT
Phone: (206) 725-8043
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.