Organization
PUYALLUP RADIOLOGICAL ASSOCS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COTY A MCREYNOLDS (BOOKKEEPER)
(253) 845-9511
Entity
Organization
Contact information
Practice address
800 S MERIDIAN, SUITE B, PUYALLUP, WA 98371-6995
(253) 845-9511
(253) 840-3513
Mailing address
800 S MERIDIAN, SUITE B, PUYALLUP, WA 98371-6995
(253) 845-9511
(253) 840-3513
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040900
DEPT LABOR & INDUSTRIES
WA
05
—
7860307
—
WA
Enumeration date
07/18/2005
Last updated
08/22/2020
Update your record
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