Organization
UP FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAI DAVALOS (MANAGER)
(253) 564-8100
Entity
Organization
Contact information
Practice address
4114 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4315
(253) 564-8100
(253) 564-8387
Mailing address
4114 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4315
(253) 564-8100
(253) 564-8387
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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