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NPI Code Detail

MEDICARE: RAINIER FOOT AND ANKLE ASSOCIATES

MEDICARE: RAINIER FOOT AND ANKLE ASSOCIATES
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
1213E00000XPodiatrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922665512
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAINIER FOOT AND ANKLE ASSOCIATES
Provider Business Mailing Address
First Line : 853 WATSON ST N STE 100
Second Line :
City : ENUMCLAW
State : WA
Zip : 98022-3948
Country : US
Telephone Number : 360-761-1285
Fax Number : 360-761-1313
Provider Business Practice Location Address
First Line : 853 WATSON ST N STE 100
Second Line :
City : ENUMCLAW
State : WA
Zip : 98022-3948
Country : US
Telephone Number : 360-761-1285
Fax Number : 360-761-1313
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : CHRISTOPHER D BOCK
Credential : DPM
Telephone Number : 360-761-1285
Provider Enumeration Date : 05/20/2019
Last Update Date : 05/20/2019

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