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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
1261QA1903XAmbulatory Surgical Clinic/Center50C0001173WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1490004506OTHERWARAILROAD MEDICARE

General Provider Information

NPI Number : 1528000155
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 : JULIE HARRISON
Credential :
Telephone Number : 425-670-8950
Provider Enumeration Date : 06/11/2006
Last Update Date : 05/31/2013

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