# METROLIANCE FOOT AND ANKLE GROUP

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

## Provider details

- **NPI number:** 1750796579
- **Authorized official:** DR. TAESOON PARK DPM (MANAGER/OWNER)
- **Authorized official phone:** (206) 707-4747

## 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
- **Mailing address fax:** (425) 893-8111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO 60234756 | WA | Yes |

## Other

- **Enumeration date:** 07/01/2014
- **Last updated:** 09/28/2015