Healthcare Provider Details

I. General information

NPI: 1528000155
Provider Name (Legal Business Name): SOUND UROLOGICAL ASSOCIATES P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 05/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21822 76TH AVE W
EDMONDS WA
98026-7900
US

IV. Provider business mailing address

21822 76TH AVE W
EDMONDS WA
98026-7900
US

V. Phone/Fax

Practice location:
  • Phone: 425-775-7166
  • Fax: 425-672-8844
Mailing address:
  • Phone: 425-775-7166
  • Fax: 425-672-8844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number50C0001173
License Number StateWA

VIII. Authorized Official

Name: JULIE HARRISON
Title or Position: ADMINISTRATOR
Credential:
Phone: 425-670-8950