is a Vascular Surgery in Renton, Washington. practices all healthcare services and medical treatments related to Vascular Surgery. The NPI Number for is 1811154537. The last update date is .
's current location address is 4033 Talbot Rd S Ste 530, Renton, Washington. You can contact this provider via phone number 4256903498 and fax number 4256909498. The mailing address for is 4033 Talbot Rd S Ste 530, Renton, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 4033 Talbot Rd S Ste 530, Renton, Washington |
| Phone Number | 4256903498 |
| Fax Number | 4256909498 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1811154537 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 4033 Talbot Rd S Ste 530 |
|---|---|
| City | Renton |
| State | Washington (WA) |
| Post Code | 980555700 |
| Phone Number | 4256903498 |
| Fax Number | 4256909498 |
Provider's Primary Taxonomy Detail
| Speciality | Vascular Surgery |
|---|---|
| Taxonomy | 2086S0129X |
| Licence No | 36115652 |
|
Definition: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1092866 | WA | -- |
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