Organization
PACIFIC PODIATRY GROUP, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN M FUSON DPM (PRESIDENT)
(253) 473-5566
Entity
Organization
Contact information
Practice address
7808 PACIFIC AVE, SUITE 1, TACOMA, WA 98408-7039
(253) 473-5566
(253) 473-6436
Mailing address
7808 PACIFIC AVE, SUITE 1, TACOMA, WA 98408-7039
(253) 473-5566
(253) 882-0988
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
600637306
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64061
LABOR & INDUSTRIES
WA
05
—
7051519
—
WA
Enumeration date
06/26/2006
Last updated
07/07/2009
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