Organization
BONNEY LAKE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYTHILI R ARIGALA M.D. (OWNER)
(253) 891-2160
Entity
Organization
Contact information
Practice address
20631 HWY 410 E., STE 303, BONNEY LAKE, WA 98390-6390
(253) 891-2160
(253) 891-2171
Mailing address
20631 HWY 410 E., STE 303, BONNEY LAKE, WA 98390-6390
(253) 891-2160
(253) 891-2171
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00036489
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1117456
—
WA
Enumeration date
03/07/2008
Last updated
03/07/2008
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