Individual
MR. MICHAEL LANE PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12904 94TH AVE EAST, PUYALLUP, WA 98373
(253) 841-3999
(253) 841-7311
Mailing address
12904 94TH AVE EAST, PUYALLUP, WA 98373
(253) 841-3999
(253) 841-7311
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00014726
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1069103
—
WA
05
—
7200058
—
WA
Enumeration date
08/20/2006
Last updated
08/24/2012
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