Organization
LAKEWOOD SURGICAL UROLOGY PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN B BAK MD (OWNER/PROVIDER)
(253) 581-7000
Entity
Organization
Contact information
Practice address
11306 BRIDGEPORT WAY SW, SUITE D, LAKEWOOD, WA 98499-3005
(253) 581-7000
(253) 984-6774
Mailing address
PO BOX 97115, LAKEWOOD, WA 98497-0115
(253) 588-7911
(253) 984-6774
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00044997
WA
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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