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Organization

NORTHWEST UROLOGY CENTER PS

Active
Other names
Robert O Modarelli MD PS
Organization subpart
No

Provider details

NPI number
Authorized official
ALIA D MODARELLI (OFFICE ADMINISTRATOR)
(253) 272-8441
Entity
Organization

Contact information

Practice address
1624 S I ST, STE 204, TACOMA, WA 98405-5016
(253) 272-8441
(253) 272-8096
Mailing address
1624 S I ST, STE 204, TACOMA, WA 98405-5016
(253) 272-8441
(253) 272-8096

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7077449
WA
Enumeration date
12/13/2006
Last updated
07/31/2007
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