Unknown Individual – Specialist, NPI 1255304317
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
4901 108TH ST SW
TACOMA, WA 984993724
Phone: (253) 589-6484
Fax: (253) 984-1079
Type: Location
post box, 74th Street West, Wispering Pines, Lakewood, Pierce County, Washington, 98499-8398, United States
LAKEWOOD, WA 984968886
Phone: (253) 589-6484
Fax: (253) 984-1079
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98499)
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