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General NPI Number Information
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NPI Number | 1902167471
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Entity Type | Organization
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Legal Business Name | ANKLE & FOOT SPECIALISTS OF PUGET SOUND, PS
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 18100 NE UNION HILL RD SUITE 200
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City | REDMOND
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State | WA
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Zip | 98052-3330
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Country | US
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Telephone | 425-644-2313
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Fax | 425-644-4739
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Provider Business Mailing Address
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Address Line | 2728 E MAIN SUITE A
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City | PUYALLUP
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State | WA
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Zip | 98372-3198
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Country | US
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Telephone | 425-644-2313
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Fax | 425-644-4739
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | CHARLES R CHU
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Credential | DPM
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Telephone | 425-449-2471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO00000277
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO00000277
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License Number State | WA
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