Organization
PLATEAU FAMILY MEDICINE, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIDRE L FEENEY MD (OWNER)
(360) 825-8300
Entity
Organization
Contact information
Practice address
853 WATSON ST N STE 200, ENUMCLAW, WA 98022-9348
(360) 825-8300
(360) 825-9255
Mailing address
853 WATSON ST N STE 200, ENUMCLAW, WA 98022-9348
(360) 825-8300
(360) 825-9255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
602444776
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7127053
—
WA
Enumeration date
08/16/2006
Last updated
07/22/2009
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