Organization
LAKEWOOD PEDIATRIC ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL TAN M.D. (MANAGING PARTNER)
(253) 581-2111
Entity
Organization
Contact information
Practice address
7424 BRIDGEPORT WAY W, STE 103, LAKEWOOD, WA 98499
(253) 581-2111
(253) 581-7479
Mailing address
7424 BRIDGEPORT WAY W, STE 103, LAKEWOOD, WA 98499
(253) 581-2111
(253) 581-7479
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0187382
PRACTICE L&I NUMBER
WA
05
—
7093628
—
WA
01
—
8925744
PRACTICE CRIME VICTIMS #
WA
Enumeration date
08/31/2006
Last updated
04/26/2017
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