| NPI | 1821478686 |
|---|---|
| Doing Business As | OPTUM - BALLARD |
| Entity Type | Organization |
| Authorized Contact | CRAIG PEPIN Physician/Owner 206-860-5414 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207Q00000X Family Medicine | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208600000X Surgery | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2024-05-24 |