Greg Sidell Md Pllc | |
4041 Ruston Way Suite 202 Tacoma WA 98402-5300 | |
(253) 693-0022 | |
Not Available |
Full Name | Greg Sidell Md Pllc |
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Speciality | Psychiatry & Neurology - Psychiatry |
Location | 4041 Ruston Way, Tacoma, Washington |
Authorized Official Name and Position | Gregory Scott Sidell (REGISTERED AGENT/EXECUTOR) |
Authorized Official Contact | 2536930022 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Greg Sidell Md Pllc 4041 Ruston Way Suite 202 Tacoma WA 98402-5300 Ph: (253) 693-0022 | Greg Sidell Md Pllc 4041 Ruston Way Suite 202 Tacoma WA 98402-5300 Ph: (253) 693-0022 |
NPI Number | 1659047298 |
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Provider Enumeration Date | 08/23/2021 |
Last Update Date | 08/23/2021 |
Certification Date | 08/23/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659047298 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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