Healthcare Provider Details

I. General information

NPI: 1669532024
Provider Name (Legal Business Name): U.S. ARMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22624 102ND PL SE
KENT WA
98031-4200
US

IV. Provider business mailing address

22624 102ND PL SE
KENT WA
98031-4200
US

V. Phone/Fax

Practice location:
  • Phone: 253-520-6248
  • Fax:
Mailing address:
  • Phone: 253-520-6248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number3444
License Number StateIA

VIII. Authorized Official

Name: DR. SCOTT A TRAPMAN
Title or Position: FAMILY MEDICINE PHYSICIAN
Credential: D.O.
Phone: 253-520-6248