Kenneth Murray Edstrom, MD | |
1701 3rd St Se, Suite 200, Puyallup, WA 98372-4511 | |
(253) 840-4444 | |
(253) 840-5239 |
Full Name | Kenneth Murray Edstrom |
---|---|
Gender | Male |
Speciality | Obstetrics & Gynecology |
Location | 1701 3rd St Se, Puyallup, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649373663 | NPI | - | NPPES |
7085020 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | MD00026074 (Washington) | Primary |
Entity Name | General Conference Corp Of Sda |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275586877 PECOS PAC ID: 6608777628 Enrollment ID: O20040114000187 |
Mailing Address | Practice Location Address |
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Kenneth Murray Edstrom, MD 1701 3rd St Se, Suite 200, Puyallup, WA 98372-4511 Ph: (253) 840-4444 | Kenneth Murray Edstrom, MD 1701 3rd St Se, Suite 200, Puyallup, WA 98372-4511 Ph: (253) 840-4444 |
Mrs. Michelle Dawn Fears, WHNP Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 400 15th Ave Se, Puyallup, WA 98372 Phone: 253-697-1310 | |
Dr. Virginia O White, Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1450 5th St Se Ste 3200, Puyallup, WA 98372 Phone: 253-697-3550 | |
Laurie J Morris, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1701 3rd St Se, Suite 200, Puyallup, WA 98372 Phone: 253-840-4444 Fax: 253-840-5239 | |
Victor L Obregon, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1703 S Meridian Ste 103, Puyallup, WA 98371 Phone: 253-848-2453 | |
Jonathan Christopher Mitchell, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 11102 Sunrise Blvd E, Suite 110, Puyallup, WA 98374 Phone: 253-697-7350 Fax: 253-841-5962 | |
Sam Hwa Song, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1408 3rd St Se, 150 & 200, Puyallup, WA 98372 Phone: 253-697-3550 | |
Bruce D Romig, Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 520 14th Ave Se, Puyallup, WA 98372 Phone: 253-845-1962 Fax: 253-770-8640 |