| NPI | 1497328330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETRINA C LEWIS Owner 425-277-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine |
| 213ES0000X Podiatrist Sports Medicine | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2023-01-05 |