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General NPI Number Information
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NPI Number | 1144706532
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Entity Type | Organization
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Legal Business Name | WA PACS 2 PC
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 4755 S 48TH ST
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City | TACOMA
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State | WA
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Zip | 98409-1919
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Country | US
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Telephone | 865-693-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 265 BROOKVIEW CENTRE WAY STE 400
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City | KNOXVILLE
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State | TN
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Zip | 37919-4052
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Country | US
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Telephone | 865-693-1000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ETHAN BACHRACH
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Credential | MD
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Telephone | 865-693-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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