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Individual

MR. MICHAEL PHILIP PODRASKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
1420 4TH ST SE, STE D, PUYALLUP, WA 98372
(253) 848-2888
(253) 848-3840
Mailing address
1420 4TH ST SE, STE D, PUYALLUP, WA 98372
(253) 848-2888
(253) 848-3840

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
WA
224P00000X
Prosthetist
Primary
PS00000022
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9018763
WA
Enumeration date
12/29/2005
Last updated
11/20/2007
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