Healthcare Provider Details

I. General information

NPI: 1992793772
Provider Name (Legal Business Name): SOUND PODIATRY P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 CAMPBELL WAY SUITE 102
BREMERTON WA
98310-3351
US

IV. Provider business mailing address

1225 CAMPBELL WAY SUITE 102
BREMERTON WA
98310-3351
US

V. Phone/Fax

Practice location:
  • Phone: 360-792-1376
  • Fax: 360-850-4333
Mailing address:
  • Phone: 360-792-1376
  • Fax: 360-850-4333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number442
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License Number442
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number442
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number442
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number442
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number442
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number442
License Number StateWA
# 8
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number442
License Number StateWA

VIII. Authorized Official

Name: DR. DAVID MICHAEL BERNSTEIN
Title or Position: DOCTOR
Credential: D.P.M.
Phone: 360-792-1376