Organization
PUGET SOUND SPECIALTY PHYSICIANS PLLC
Active
Parent organization
PUGET SOUND SPECIALTY PHYSICIANS PLLC
Other names
Ankle & Foot Specialist of Bonney Lake
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUGET SOUND SPECIALTY PHYSICIANS PLLC
Authorized official
TINA M QUEVEDO (BILLING OFFICE SUPERVISOR)
(253) 841-2006
Entity
Organization
Contact information
Practice address
19820 HWY 410 EAST, BONNEY LAKE, WA 98391
(253) 848-6656
(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
—
WA
Other
Enumeration date
11/23/2007
Last updated
06/05/2008
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