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Organization

BROADWAY FOOT & ANKLE PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BARRY L LICHTER DPM (SOLE PROPRIETOR)
(206) 386-2800
Entity
Organization

Contact information

Practice address
6625 W CREST VIEW LOOP SE, SNOQUALMIE, WA 98065-8912
(425) 396-5424
Mailing address
PO BOX 24963, SEATTLE, WA 98124-0963
(206) 320-4476
(206) 320-5340

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
193384900
WASHINGTON LABOR & INDUSTRY
WA
Enumeration date
06/04/2006
Last updated
06/25/2008
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