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Individual

EDWARD E WAKATAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1007 39TH AVE SE, PUYALLUP, WA 98374-2192
(253) 435-3100
Mailing address
1007 39TH AVE SE, PUYALLUP, WA 98374-2192
(253) 435-3100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00039599
WA

Other

Enumeration date
07/10/2006
Last updated
05/10/2021
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