Healthcare Provider Details

I. General information

NPI: 1073799615
Provider Name (Legal Business Name): VALLEY SURGICAL ASSOCIATES, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 TALBOT RD S STE 420
RENTON WA
98055-5791
US

IV. Provider business mailing address

4011 TALBOT RD S STE 420
RENTON WA
98055-5791
US

V. Phone/Fax

Practice location:
  • Phone: 425-251-1322
  • Fax: 425-656-4063
Mailing address:
  • Phone: 425-251-1322
  • Fax: 425-656-4063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WAYNE M LAU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 425-251-1322