Healthcare Provider Details

I. General information

NPI: 1053460170
Provider Name (Legal Business Name): PULMONARY CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34509 9TH AVE S SUITE 104
FEDERAL WAY WA
98003-6700
US

IV. Provider business mailing address

316 MARTIN LUTHER KING JR WAY SUITE 401
TACOMA WA
98405-4252
US

V. Phone/Fax

Practice location:
  • Phone: 253-572-5140
  • Fax: 253-272-0419
Mailing address:
  • Phone: 253-572-5140
  • Fax: 253-272-0419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JUNE MARIE DAWKINS
Title or Position: ADMINISTRATION MANAGER
Credential:
Phone: 253-572-5140