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General NPI Number Information
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NPI Number | 1245926195
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Entity Type | Organization
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Legal Business Name | PUGET SOUND MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 21616 76TH AVE W STE 202
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City | EDMONDS
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State | WA
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Zip | 98026-7543
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Country | US
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Telephone | 425-585-2452
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Fax | 425-209-3368
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Provider Business Mailing Address
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Address Line | 9249 25TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98117-2812
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Country | US
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Telephone | 425-585-2452
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Fax | 425-209-3368
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Authorized Official
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Title or Position | OWNER/MD
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Name | AMBER FAROOK
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Credential | MD
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Telephone | 509-969-6057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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