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Organization

PUGET SOUND SURGICAL ASSISTANTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH RICK HARADA PA (PHYSICIAN ASSISTANT)
(425) 327-7442
Entity
Organization

Contact information

Practice address
14712 134TH CT NE, WOODINVILLE, WA 98072-4615
(425) 327-7442
Mailing address
PO BOX 2656, WOODINVILLE, WA 98072-2656
(425) 327-7442

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10004021
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1346293107
NPI
WA
01
1447276183
NPI
Enumeration date
02/24/2010
Last updated
07/24/2012
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