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NPI Code Detail

MEDICARE: SOUND UROLOGICAL ASSOCIATES P.S.

MEDICARE: SOUND UROLOGICAL ASSOCIATES P.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianBL005871WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CS9060OTHERWARAILROAD MEDICARE

General Provider Information

NPI Number : 1265574164
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUND UROLOGICAL ASSOCIATES P.S.
Provider Business Mailing Address
First Line : 21822 76TH AVE W
Second Line :
City : EDMONDS
State : WA
Zip : 98026-7900
Country : US
Telephone Number : 425-775-7166
Fax Number : 425-672-8844
Provider Business Practice Location Address
First Line : 21822 76TH AVE W
Second Line :
City : EDMONDS
State : WA
Zip : 98026-7900
Country : US
Telephone Number : 425-775-7166
Fax Number : 425-672-8844
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. EVA M SAMTAMANN
Credential :
Telephone Number : 425-775-7166
Provider Enumeration Date : 02/14/2007
Last Update Date : 12/09/2013

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