Puget Sound Specialty Physicans PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PUGET SOUND SPECIALTY PHYSICANS PLLC

Doing business as

Kent Foot & Ankle Clinic

Practice address

17700 SE 272ND St
Suite 370
Covington, WA 98042-4951

Phone

(253) 631-0585

Fax

(253) 631-0596

NPI assigned

Oct 30, 2007

Last updated

Jun 5, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

PUGET SOUND SPECIALTY PHYSICIANS PLLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tina M Quevedo

Title

Billing Office Supervisor

Phone

(253) 841-2006

Specialties & licenses 1

Addresses

Other names 1

• Kent Foot & Ankle Clinic Doing business as

Part of

Puget Sound Specialty Physicans PLLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1568641132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 E MAIN AVE",
            "address_2": "SUITE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723198",
            "telephone_number": "253-841-2006",
            "fax_number": "253-840-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 SE 272ND ST",
            "address_2": "SUITE 370",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424951",
            "telephone_number": "253-631-0585",
            "fax_number": "253-631-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND SPECIALTY PHYSICANS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUGET SOUND SPECIALTY PHYSICIANS PLLC",
        "enumeration_date": "2007-10-30",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "QUEVEDO",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "253-841-2006"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kent Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Covington, WA
• Providers in Covington, WA by specialty
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.