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Organization

ENTPSA PUYALLUP ASC

Active
Parent organization
EAR, NOSE, THROAT & PLASTIC SURGERY ASSOCIATES
Organization subpart
Yes

Provider details

NPI number
Legal business name
EAR, NOSE, THROAT & PLASTIC SURGERY ASSOCIATES
Authorized official
DR. CHRISTINE M PUIG MD (PRESIDENT)
(253) 833-6241
Entity
Organization

Contact information

Practice address
1609 S MERIDIAN, PUYALLUP, WA 98371-7517
(253) 833-6241
(253) 833-4113
Mailing address
310 6TH ST NE, AUBURN, WA 98002-4342
(253) 833-6241
(253) 833-4113

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3535EN
REGENCE
WA
05
7133671
WA
Enumeration date
07/01/2009
Last updated
09/15/2009
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