Individual
LOREN B BETTERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3733 S THOMPSON AVE, TACOMA, WA 98418-5013
(253) 472-4473
(253) 474-3056
Mailing address
3733 S THOMPSON AVE, TACOMA, WA 98418-5013
(253) 472-4473
(253) 474-3056
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28116
WA
207QS0010X
Sports Medicine (Family Medicine) Physician
28116
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1065390
—
WA
Enumeration date
07/01/2005
Last updated
08/03/2007
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