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General NPI Number Information
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NPI Number | 1598713273
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Entity Type | Organization
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Legal Business Name | SOUND MEDICAL IMAGING PLLC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 12615 MERIDIAN EAST, STE 3
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City | PUYALLUP
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State | WA
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Zip | 98373-3426
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Country | US
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Telephone | 253-435-5195
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 731301
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City | PUYALLUP
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State | WA
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Zip | 98373-3426
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Country | US
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Telephone | 253-435-5195
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDER SERRA
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Credential | MD
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Telephone | 253-435-5195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD00044456
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License Number State | WA
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