| |
9909 224th St E, Suite 120, Graham, WA 98338-7086 | |
(253) 875-7375 | |
(253) 873-7571 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 9909 224th St E, Graham, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396843678 | NPI | - | NPPES |
1184640575 | Other | WA | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | PO00000658 (Washington) | Primary |
Mailing Address | Practice Location Address |
---|---|
9909 224th St E, Suite 120, Graham, WA 98338-7086 Ph: (253) 875-7375 | 9909 224th St E, Suite 120, Graham, WA 98338-7086 Ph: (253) 875-7375 |