# METROLIANCE FOOT AND ANKLE GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eastside Podiatry ASC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740408293
- **Authorized official:** DR. TAE SOON PARK D.P.M. (MEDICAL DIRECTOR)
- **Authorized official phone:** (425) 893-8100

## Contact information

- **Practice address:** 2950 NORTHUP WAY, SUITE 115, BELLEVUE, WA 98004-1406
- **Practice address phone:** (425) 893-8100
- **Practice address fax:** (425) 893-8111
- **Mailing address:** 2950 NORTHUP WAY, SUITE 115, BELLEVUE, WA 98004-1406
- **Mailing address phone:** (425) 893-8100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 301 | WA | Yes |

## Other

- **Enumeration date:** 04/22/2007
- **Last updated:** 09/28/2015