Healthcare Provider Details

I. General information

NPI: 1558885210
Provider Name (Legal Business Name): SOUND INTEGRATED HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 S CEDAR ST STE M
TACOMA WA
98409-5700
US

IV. Provider business mailing address

PO BOX 65695
UNIVERSITY PLACE WA
98464-1695
US

V. Phone/Fax

Practice location:
  • Phone: 253-478-0827
  • Fax: 253-799-7197
Mailing address:
  • Phone: 253-651-2498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD35804
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberMD35804
License Number StateWA

VIII. Authorized Official

Name: DR. ATIF MIAN
Title or Position: MD
Credential: MD
Phone: 253-651-2486