# SOUTH SOUND INPATIENT PHYSICIANS, PLLC

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

## Provider details

- **NPI number:** 1962806174
- **Authorized official:** ANDREA GOFF (VP, REV CYCLE)
- **Authorized official phone:** (253) 682-1710

## Contact information

- **Practice address:** 1123 PACIFIC AVE, TACOMA, WA 98402-4303
- **Practice address phone:** (253) 682-1710
- **Mailing address:** 400 W SEVENTH ST, FREDERICK, MD 21701-4506
- **Mailing address phone:** (240) 566-3300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | Yes |
| 208M00000X | Hospitalist Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/17/2014
- **Last updated:** 10/17/2014