Organization
CEDAR MEDICAL SPECIALTIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN WALLACE (PRACTICE MANAGER)
(253) 759-5555
Entity
Organization
Contact information
Practice address
2202 S CEDAR ST, STE 100, TACOMA, WA 98405-2318
(253) 759-5555
(253) 830-5420
Mailing address
2202 S CEDAR ST, STE 100, TACOMA, WA 98405-2318
(253) 759-5555
(253) 830-5420
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
FX00057086
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7110224
—
WA
Enumeration date
06/22/2005
Last updated
08/22/2020
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