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General NPI Number Information
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NPI Number | 1083583801
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Entity Type | Organization
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Legal Business Name | PRECISION PROCTOLOGY & AESTHETICS
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 6808 220TH ST SW STE 200
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2187
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Country | US
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Telephone | 425-515-0276
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Fax |
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Provider Business Mailing Address
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Address Line | 6808 220TH ST SW STE 200
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2187
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Country | US
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Telephone | 425-515-0276
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RODNEY KRATZ
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Credential | MD
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Telephone | 206-419-7929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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