# ASSOCIATED VALLEY PROVIDERS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316249907
- **Authorized official:** MARIANNE BROERS (MD)
- **Authorized official phone:** (425) 255-5111

## Contact information

- **Practice address:** 4361 TALBOT RD S STE 112, RENTON, WA 98055-6226
- **Practice address phone:** (425) 255-5111
- **Practice address fax:** (425) 254-0985
- **Mailing address:** 4361 TALBOT RD S STE 112, RENTON, WA 98055-6226
- **Mailing address phone:** (425) 255-5111
- **Mailing address fax:** (425) 254-0985

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD00032726 | WA | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO00000396 | WA | — |
| 363L00000X | Nurse Practitioner | AP30004306 | WA | — |

## Other

- **Enumeration date:** 12/02/2010
- **Last updated:** 12/02/2010