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Individual

MICHAEL J SKROCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA C

Contact information

Practice address
21601 76TH AVENUE WEST, EDMONDS, WA 98026-7507
(425) 640-4000
(425) 640-4010
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003431
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0143598
LABOR AND INDUSTRIES
WA
01
0143756
LIWA
WA
01
0562SK
BSWA
WA
05
8318693
WA
Enumeration date
12/08/2006
Last updated
06/03/2008
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