| NPI | 1750796579 |
|---|---|
| Doing Business As | EASTSIDE PODIATRY CLINIC |
| Entity Type | Organization |
| Authorized Contact | TAESOON PARK Manager/Owner 206-707-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: WA PO 60234756) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2015-09-28 |