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Organization

ASSOCIATED VALLEY PROVIDERS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIANNE BROERS (MD)
(425) 255-5111
Entity
Organization

Contact information

Practice address
4361 TALBOT RD S STE 112, RENTON, WA 98055-6226
(425) 255-5111
(425) 254-0985
Mailing address
4361 TALBOT RD S STE 112, RENTON, WA 98055-6226
(425) 255-5111
(425) 254-0985

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00032726
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
PO00000396
WA
363L00000X
Nurse Practitioner
AP30004306
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7112634
WA
Enumeration date
12/02/2010
Last updated
12/02/2010
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