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NPI Code Detail

MEDICARE: PUGET SOUND SURGICAL CLINIC INC

MEDICARE: PUGET SOUND SURGICAL CLINIC INC
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
1208600000XSurgery Physician

General Provider Information

NPI Number : 1699785527
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUGET SOUND SURGICAL CLINIC INC
Provider Business Mailing Address
First Line : 19930 BALLINGER WAY NE
Second Line :
City : SHORELINE
State : WA
Zip : 98155-1223
Country : US
Telephone Number : 425-778-2220
Fax Number : 425-778-7701
Provider Business Practice Location Address
First Line : 19930 BALLINGER WAY NE
Second Line :
City : SHORELINE
State : WA
Zip : 98155-1223
Country : US
Telephone Number : 425-778-2220
Fax Number : 425-778-7701
Authorized Official
Title or Position : OPERATIONS MANAGER
Name : CHERYL HAMILL
Credential :
Telephone Number : 425-778-2220
Provider Enumeration Date : 08/09/2006
Last Update Date : 09/26/2018

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