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NPI Code Detail

MEDICARE: ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS

MEDICARE: ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS
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
1213E00000XPodiatristPO00000277WA

General Provider Information

NPI Number : 1841578705
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS
Provider Business Mailing Address
First Line : 2728 E MAIN AVE STE A
Second Line :
City : PUYALLUP
State : WA
Zip : 98372-3198
Country : US
Telephone Number : 253-841-2006
Fax Number :
Provider Business Practice Location Address
First Line : 10004 204TH AVE E STE 2700
Second Line :
City : BONNEY LAKE
State : WA
Zip : 98391-6535
Country : US
Telephone Number : 253-848-6656
Fax Number :
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : CHARLES R CHU
Credential : DPM
Telephone Number : 425-449-2471
Provider Enumeration Date : 07/26/2011
Last Update Date : 03/26/2012

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Directions to “ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS ” Practice Location

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