Organization
CREEKSIDE ORTHOPEDICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S PLACE MD (CEO)
(509) 457-1900
Entity
Organization
Contact information
Practice address
3907 CREEKSIDE LOOP, STE. 100, YAKIMA, WA 98902-4879
(509) 457-1900
(509) 853-2700
Mailing address
PO BOX 8051, YAKIMA, WA 98908-0051
(509) 469-1903
(509) 469-1905
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0012321
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197897
LABOR AND INDUSTRIES
WA
05
—
7126642
—
WA
Enumeration date
08/02/2005
Last updated
08/16/2011
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