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Organization

PACIFIC MEDICAL DIALYSIS SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES MINN MD (MD)
(855) 621-8250
Entity
Organization

Contact information

Practice address
3020 S UNION AVE, TACOMA, WA 98409-3317
(253) 310-2236
Mailing address
3020 S UNION AVE, TACOMA, WA 98409-3317

Taxonomy

Speciality
Code
Description
License number
State
163WD1100X
Peritoneal Dialysis Registered Nurse
163WH0500X
Hemodialysis Registered Nurse
207RN0300X
Nephrology Physician
Primary
2472R0900X
Renal Dialysis Technician
332BD1200X
Dialysis Equipment & Supplies (DME)

Other

Enumeration date
10/24/2023
Last updated
11/10/2023
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