Organization
NORTHWEST FOOT AND ANKLE CENTER, PS
Active
Other names
Mark Lewis
Organization subpart
No
Provider details
NPI number
Authorized official
MATT ROTH (OFFICE MANAGER)
(425) 277-3668
Entity
Organization
Contact information
Practice address
11212 SUNRISE BLVD E, SUITE 203, PUYALLUP, WA 98374-8847
(253) 841-4262
(253) 841-7112
Mailing address
11212 SUNRISE BLVD E, SUITE 203, PUYALLUP, WA 98374-8847
(253) 841-4262
(253) 841-7112
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000660
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7142938
—
WA
Enumeration date
01/31/2008
Last updated
07/28/2021
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