Organization
EAR, NOSE, THROAT & ALLERGY ASSOICATIES PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL BENNETT M.D. (OWNER)
(253) 770-8454
Entity
Organization
Contact information
Practice address
104 27TH AVE SE, PUYALLUP, WA 98374-1145
(253) 770-8454
(253) 770-8992
Mailing address
104 27TH AVE SE, PUYALLUP, WA 98374-1145
(253) 770-8454
(253) 770-8992
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
LD60130143
WA
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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