Organization
VA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK CARROLL KUSANDER (RN)
(253) 686-7017
Entity
Organization
Contact information
Practice address
13119 149TH ST E, PUYALLUP, WA 98374-9487
(253) 686-7017
Mailing address
13119 149TH ST E, PUYALLUP, WA 98374-9487
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
RN00163709
WA
Other
Enumeration date
09/17/2007
Last updated
09/17/2007
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