Organization
WESTERN WASHINGTON PATHOLOGY PS
Active
Other names
Pathology Associates of Tacoma PS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROB ROY ROTH M.D. (SECRETARY)
(253) 403-1043
Entity
Organization
Contact information
Practice address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 403-1043
(253) 403-1357
Mailing address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 403-1043
(253) 403-1357
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
601053749
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50D0718142
CLIA
WA
05
—
7020142
—
WA
01
—
MTS2713
WASH MEDICAL TEST SITE
WA
Enumeration date
01/31/2007
Last updated
08/25/2008
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