Provider Demographics
NPI:1619859329
Name:PREEMPTIVE CLINIC
Entity type:Organization
Organization Name:PREEMPTIVE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCULLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-814-4524
Mailing Address - Street 1:1522 WESTERN AVE STE 24105
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1522
Mailing Address - Country:US
Mailing Address - Phone:650-814-4524
Mailing Address - Fax:
Practice Address - Street 1:5283 HAWKESBURY WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-9582
Practice Address - Country:US
Practice Address - Phone:148-069-5812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center