Healthcare Provider Details

I. General information

NPI: 1063737096
Provider Name (Legal Business Name): AUBURN REGIONAL MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34520 16TH AVE S
FEDERAL WAY WA
98003-6802
US

IV. Provider business mailing address

PO BOX 399
AUBURN WA
98071-0399
US

V. Phone/Fax

Practice location:
  • Phone: 253-656-0223
  • Fax: 253-872-7900
Mailing address:
  • Phone: 253-447-4770
  • Fax: 253-447-4771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVE PATONAI
Title or Position: CEO
Credential:
Phone: 253-447-4770