Organization
METROLIANCE FOOT AND ANKLE GROUP
Active
Other names
Eastside Podiatry ASC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAE SOON PARK D.P.M. (MEDICAL DIRECTOR)
(425) 893-8100
Entity
Organization
Contact information
Practice address
2950 NORTHUP WAY, SUITE 115, BELLEVUE, WA 98004-1406
(425) 893-8100
(425) 893-8111
Mailing address
2950 NORTHUP WAY, SUITE 115, BELLEVUE, WA 98004-1406
(425) 893-8100
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
301
WA
Other
Enumeration date
04/22/2007
Last updated
09/28/2015
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