COUNTRY DOCTOR CLINIC-MATERNAL SUPPORT SERVICES
NPI 1316138696
Case Manager/Care Coordinator in Seattle, WA

Active since August 05, 2007CLIA 50D0632210 · Certificate of Compliance
500 19TH AVE E, SEATTLE, WA 98112(206) 299-1600(206) 299-1608 Get Directions Write a Review

NPPES record last updated: June 25, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Country Doctor Clinic-maternal Support Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY DOCTOR CLINIC-MATERNAL SUPPORT SERVICES (NPI 1316138696) is a healthcare organization registered as a case manager/care coordinator in Seattle, Washington and active in the NPI registry since August 2007. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028 and lists Shonnie Evans, Qi Manager, as its authorized official.

NPPES Registry Identity

NPI1316138696
Entity TypeOrganization
Primary Taxonomy171M00000X
Legal Business NameCOUNTRY DOCTOR COMMUNITY CLINIC
Location Address500 19TH AVE ESeattle, WA 98112-4007
Mailing Address500 19th Ave ESeattle, WA 98112-4007 · (206) 299-1600 · Fax (206) 299-1608
Fax(206) 299-1608
Organization SubpartNo
Authorized OfficialShonnie EvansQi Manager · (206) 299-1984
Enumeration DateAugust 5, 2007
Last NPPES UpdateJune 25, 2008
NPI 1316138696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers
Taxonomy Code171M00000X
Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

500 19TH AVE E, Seattle, WA 98112

Other Names 1

Doing Business AsCountry Doctor Clinic-maternal Support Services

Other Identifiers 1

Medicaid7402852WA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 50D0632210

Country Doctor Clinic Laboratory · Seattle, WA
Active · expires Apr 4, 2028
CLIA Number50D0632210
Laboratory TypeCommunity Clinic
Certificate Effective DateNovember 1, 1993
Certificate Expiration DateApril 4, 2028
Laboratory DirectorMatthew J. Logalbo
Laboratory Phone(206) 299-1600
Laboratory LocationCountry Doctor Clinic Laboratory500 19th Ave E, Seattle, WA 98112
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
500 19TH AVE E
SEATTLE, WA 98112
Social Worker (Clinical)
500 19TH AVE E
SEATTLE, WA 98112
Case Manager/Care Coordinator
500 19TH AVE E
SEATTLE, WA 98112
Pharmacist
500 19TH AVE E
SEATTLE, WA 98112
Social Worker (Clinical)
500 19TH AVE E
SEATTLE, WA 98112
Social Worker
500 19TH AVE E
SEATTLE, WA 98112
Family Medicine
500 19TH AVE E
SEATTLE, WA 98112
Registered Nurse
500 19TH AVE E
SEATTLE, WA 98112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Country Doctor Community Clinic's NPI number?

The NPI number for Country Doctor Community Clinic is 1316138696. It was assigned to this organization in the NPPES registry on August 5, 2007. The provider is doing business as Country Doctor Clinic-Maternal Support Services.

Where is Country Doctor Community Clinic located?

Country Doctor Community Clinic is located at 500 19th Ave E, Seattle, WA 98112. The listed phone number is (206) 299-1600.

What is Country Doctor Community Clinic's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Does Country Doctor Community Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D0632210) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Country Doctor Community Clinic was last updated on June 25, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.