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Organization

SOUTH SOUND SURGERY, PLLC

Active
Parent organization
SOUTH SOUND SURGERY, PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTH SOUND SURGERY, PLLC
Authorized official
JOHN CONRAD (OWNER)
(253) 394-0125
Entity
Organization

Contact information

Practice address
101 2ND ST NE, AUBURN, WA 98002-4902
(253) 394-0125
Mailing address
PO BOX 1409, AUBURN, WA 98071-1409
(253) 394-0125

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00046250
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7135429
WA
Enumeration date
05/23/2006
Last updated
05/26/2011
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