Organization
PUGET SOUND SPECIALTY PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA M QUEVEDO (BILLING SUPERVISOR)
(253) 841-2006
Entity
Organization
Contact information
Practice address
2728 E MAIN AVE, SUITE A, PUYALLUP, WA 98372-3198
(253) 841-2006
(253) 840-6691
Mailing address
2728 E MAIN AVE, SUITE A, PUYALLUP, WA 98372-3198
(253) 841-2006
(253) 840-6691
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7109770
—
WA
Enumeration date
12/28/2007
Last updated
06/14/2010
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