Healthcare Provider Details

I. General information

NPI: 1275720831
Provider Name (Legal Business Name): PAULUS D TSAI MD PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 BOGACHIEL WAY
FORKS WA
98331-9120
US

IV. Provider business mailing address

PO BOX 2196
SEQUIM WA
98382-2196
US

V. Phone/Fax

Practice location:
  • Phone: 360-374-6998
  • Fax: 360-374-3162
Mailing address:
  • Phone: 360-461-3636
  • Fax: 360-683-6488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD00043281
License Number StateWA

VIII. Authorized Official

Name: DR. PAULUS DARCY TSAI
Title or Position: PRESIDENT
Credential: MD
Phone: 360-461-3636