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ANKLE & FOOT SPECIALIST OF PUGET SOUND PS NPI 1841578705


NPI Information

NPI: 1841578705
Provider Name: ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS

Doing Business As: ANKLE & FOOT SPECIALIST OF BONNEY LAKE

Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
10004 204TH AVE E STE 2700
BONNEY LAKE, WA
ZIP 98391
Phone: (253) 848-6656
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ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS is a podiatrist in Bonney Lake, WA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS NPI is 1841578705. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ankle & Foot Specialist Of Bonney Lake.

The provider's business location address is:

10004 204TH AVE E STE 2700
BONNEY LAKE, WA
ZIP 98391-535
Phone: (253) 848-6656

The provider's authorized official is Charles R Chu .
The authorized official title is Physician/owner and has the following contact phone number (425) 449-2471.

The enumeration date for this NPI number is 7/26/2011 and was last updated on 3/26/2012.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristPO00000277WASHINGTONYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G8906838MEDICARE PINWASHINGTON

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: 5/5/2024

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