Charles V Edmond Jr, MD | |
104 27th Ave Se, Puyallup, WA 98374-1145 | |
(253) 770-9000 | |
(253) 770-9712 |
Full Name | Charles V Edmond Jr |
---|---|
Gender | Male |
Speciality | Otolaryngology |
Experience | 40 Years |
Location | 104 27th Ave Se, Puyallup, Washington |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851327324 | NPI | - | NPPES |
8145229 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Y00000X | Otolaryngology | MD30364 (Washington) | Primary |
207YS0123X | Otolaryngology - Facial Plastic Surgery | MD00030364 (Washington) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Multicare Good Samaritan Hospital | Puyallup, WA | Hospital |
Tacoma General Allenmore Hospital | Tacoma, WA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Proliance Surgeons Inc Ps | 8527972900 | 358 |
Entity Name | Proliance Surgeons Inc Ps |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023170313 PECOS PAC ID: 8527972900 Enrollment ID: O20031119000128 |
Mailing Address | Practice Location Address |
---|---|
Charles V Edmond Jr, MD Po Box 1205, Puyallup, WA 98371-0231 Ph: (253) 770-9000 | Charles V Edmond Jr, MD 104 27th Ave Se, Puyallup, WA 98374-1145 Ph: (253) 770-9000 |
Dr. Todd Dwyer Jones, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 | |
Dr. Dennis R. Elonka, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 6415 82nd St E, Puyallup, WA 98371 Phone: 253-691-0823 | |
Vivian Mae Yu, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 | |
Christopher P. Lenkeit, DO Otolaryngology Medicare: Medicare Enrolled Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 | |
Julie Allina Gustafson, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-848-0368 Fax: 253-435-4937 | |
Randall Paul Bennett, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 | |
Douglas D Backous, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 |