| NPI | 1003074410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH D DE VEAUX Business Office Manager 253-722-0485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |