Puget Sound Specialty Physicians PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PUGET SOUND SPECIALTY PHYSICIANS PLLC

Practice address

2820 Griffin Ave
Suite 101
Enumclaw, WA 98022-2373

Phone

(253) 841-2006

Fax

(253) 840-6691

NPI assigned

Dec 7, 2007

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

• Enumclaw Foot & Ankle Clinic Doing business as

Part of

Puget Sound Spec Phys PLLC

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1770766271",
    "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": "2820 GRIFFIN AVE",
            "address_2": "SUITE 101",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222373",
            "telephone_number": "253-841-2006",
            "fax_number": "253-840-6691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND SPECIALTY PHYSICIANS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUGET SOUND SPECIALTY PHYSICIANS PLLC",
        "enumeration_date": "2007-12-07",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enumclaw Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Plateau Rehab Services
• Heidi Poortvliet
• Gouri Bhawan Pothini, M.D.
• Jamie Lynn Prak
• Kristine Princehouse
• Puget Sound Specialty Physicians, PLLC
• Jamie D Purple, LMP
• Julianna Dionne Pyle Vanhoof, COTA/L
• Patricia Ann Reyes Quaine, M.D.
• Quezada Enterprises Inc

• Foot & Ankle Surgery Podiatrist in Enumclaw, WA
• Providers in Enumclaw, 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.