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General NPI Number Information
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NPI Number | 1205903515
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Entity Type | Organization
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Legal Business Name | ANKLE & FOOT CLINIC OF RENTO
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 275 SW 41ST ST
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City | RENTON
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State | WA
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Zip | 98057-4930
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Country | US
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Telephone | 425-251-9174
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Fax | 425-251-0758
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Provider Business Mailing Address
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Address Line | 275 SW 41ST ST
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City | RENTON
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State | WA
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Zip | 98057-4930
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Country | US
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Telephone | 425-251-9174
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Fax | 425-251-0758
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. GERALD T KUWADA
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Credential | DPM
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Telephone | 425-251-9174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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