Organization
NORTHWEST MEDICAL SPECIALTIES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK V NELSON (CEO)
(253) 428-8700
Entity
Organization
Contact information
Practice address
2920 S MERIDIAN, SUITE 100, PUYALLUP, WA 98373-1428
(253) 841-4296
(253) 841-2435
Mailing address
1624 S I ST, SUITE 305, TACOMA, WA 98405-5016
(253) 428-8700
(253) 383-3376
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD60274322
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD60274322
LICENSE
WA
Enumeration date
01/05/2015
Last updated
01/05/2015
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