Organization
BALLINGER CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROCKY WILLIAM MAZZEO MD (OWNER PARTNER)
(425) 640-4830
Entity
Organization
Contact information
Practice address
6007B 244TH ST SW, MOUNTLAKE TERRACE, WA 98043-5400
(425) 640-4830
(425) 640-4885
Mailing address
6007B 244TH ST SW, MOUNTLAKE TERRACE, WA 98043-5400
(425) 640-4830
(425) 640-4885
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WA
207R00000X
Internal Medicine Physician
—
WA
225100000X
Physical Therapist
—
WA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7073596
—
WA
Enumeration date
10/06/2006
Last updated
10/31/2008
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