Organization
GREG SIDELL MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY SCOTT SIDELL M.D. (REGISTERED AGENT/EXECUTOR)
(253) 693-0022
Entity
Organization
Contact information
Practice address
4041 RUSTON WAY, SUITE 202, TACOMA, WA 98402-5300
(253) 693-0022
Mailing address
4041 RUSTON WAY, SUITE 202, TACOMA, WA 98402-5300
(253) 693-0022
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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