Organization · Type 2 NPI

Puget Sound Specialty Physicians PLLC

Foot & Ankle Surgery Podiatrist · Bonney Lake, WA

NPI number 1144401704 Active

Practice location

19820 Hwy 410 East
Bonney Lake, WA 98391

Call (253) 848-6656 Map

Fax (253) 840-6691

Mailing address

2728 E Main Ave, Suite A
Puyallup, WA 98372-3198

Specialties and licenses

Taxonomy	Code	License
Foot & Ankle Surgery Podiatrist Primary	213ES0103X	None listed

Foot & Ankle Surgery Podiatrist: Definition to come...

NPI record

NPI: 1144401704
Entity type: Organization (Type 2)
Issued: Nov 23, 2007
Last updated: Jun 5, 2008
Status: Active
Subpart: Yes of Puget Sound Specialty Physicians PLLC

Other names

<unavail>
Ankle & Foot Specialist of Bonney Lake · doing business as

Authorized official

Tina M Quevedo
Billing Office Supervisor
(253) 841-2006

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1144401704

Puget Sound Specialty Physicians PLLC's National Provider Identifier is 1144401704, issued on Nov 23, 2007. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Bonney Lake, WA. The record was last updated on Jun 5, 2008.