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Individual

RONALD S SORENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2728 E MAIN AVE, SUITE A, PUYALLUP, WA 98372-3198
(253) 848-0131
(253) 840-6787
Mailing address
2728 E MAIN AVE, SUITE A, PUYALLUP, WA 98372-3198
(253) 841-2006
(253) 840-6691

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000510
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
PO00000510
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0155721
LABOR AND INDUSTRIES
WA
05
8148843
WA
01
CJ4574
RAIL ROAD MEDICARE
WA
01
SO1011
REGENCE
WA
Enumeration date
09/15/2005
Last updated
01/06/2014
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