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General NPI Number Information
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NPI Number | 1669845327
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Entity Type | Organization
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Legal Business Name | UNITED WOUND HEALING PS
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Dates
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Enumeration Date | 11/03/2015
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 413 29TH ST NE STE I
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City | PUYALLUP
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State | WA
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Zip | 98372-7154
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Country | US
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Telephone | 855-255-1750
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Fax | 855-255-0905
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Provider Business Mailing Address
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Address Line | 413 29TH ST NE STE I
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City | PUYALLUP
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State | WA
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Zip | 98372-7154
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Country | US
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Telephone | 855-255-1750
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Fax | 855-255-0905
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Authorized Official
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Title or Position | CEO
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Name | RYAN P DIRKS
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Credential | PA
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Telephone | 855-255-1750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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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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