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Physicians Family Medicine Adult Medicine

Provider NPI: 1164548244

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
22236 7TH AVE S  DES MOINES, WA 98198-6220 US
Tel: 206-878-8600  Fax: 206-878-4001

Business Mailing Address:
22236 7TH AVE S  DES MOINES, WA 98198-6220 US
Tel: 206-878-8600  Fax: 206-878-4001

NPI Information:
NPI: 1164548244
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Family Medicine
Adult Medicine
Family Medicine
Pain Medicine

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207QA0505X





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