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NORTHWEST UROLOGY CENTER PS NPI 1790846509


NPI Information

NPI: 1790846509
Provider Name: NORTHWEST UROLOGY CENTER PS

Former Legal Business Name: ROBERT O MODARELLI MD PS

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1624 S I ST
STE 204
TACOMA, WA
ZIP 98405
Phone: (253) 272-8441
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NORTHWEST UROLOGY CENTER PS is a specialist in Tacoma, WA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. NORTHWEST UROLOGY CENTER PS NPI is 1790846509. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Robert O Modarelli Md Ps.

The provider's business location address is:

1624 S I ST
STE 204
TACOMA, WA
ZIP 98405-016
Phone: (253) 272-8441
Fax: (253) 272-8096

The provider's authorized official is Alia D Modarelli .
The authorized official title is Office Administrator and has the following contact phone number (253) 272-8441.

The enumeration date for this NPI number is 12/13/2006 and was last updated on 7/31/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistWASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17077449MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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