Organization
NORTHWEST MEDICAL SPECIALTIES, PLLC
Active
Organization
NORTHWEST MEDICAL SPECIALTIES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK V NELSON (CHIEF EXECUTIVE OFFICER)
(253) 428-8700
Entity
Organization
Contact information
Practice address
1624 S I ST, SUITE 305, TACOMA, WA 98405-5016
(253) 428-8700
(253) 383-3376
Mailing address
1624 S I ST, SUITE 305, TACOMA, WA 98405-5016
(253) 428-8700
(253) 383-3376
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MTSC.FS.00003379
WA
207RH0003X
Hematology & Oncology Physician
MTSC.FS.00003379
WA
207RI0200X
Infectious Disease Physician
MTSC.FS.00003379
WA
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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