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General NPI Number Information
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NPI Number | 1508907106
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Entity Type | Organization
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Legal Business Name | SOUND SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1322 3RD ST SE SUITE 220
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City | PUYALLUP
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State | WA
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Zip | 98372-3771
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Country | US
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Telephone | 253-697-4140
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Fax | 253-697-4149
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Provider Business Mailing Address
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Address Line | 1322 3RD ST SE SUITE 220
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City | PUYALLUP
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State | WA
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Zip | 98372-3771
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Country | US
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Telephone | 253-697-4140
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Fax | 253-697-4149
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Authorized Official
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Title or Position | OWNER
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Name | KATHLEEN MANNING
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Credential | MD
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Telephone | 253-697-4140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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