Provider Demographics
NPI:1053567008
Name:ADAMS, ARCHIE (MD)
Entity type:Individual
Prefix:
First Name:ARCHIE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4011 TALBOT RD S STE 300
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5791
Mailing Address - Country:US
Mailing Address - Phone:425-656-5060
Mailing Address - Fax:425-656-5047
Practice Address - Street 1:27005 168TH PL SE STE 201
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4902
Practice Address - Country:US
Practice Address - Phone:253-630-3660
Practice Address - Fax:253-631-1591
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60075012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2003274Medicaid