NPI 1700902368

Northwest Cardiovascular

Organisation Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Tacoma, WA

Practice location

Address: 1812 S J St Suite 210, Tacoma, WA 98405-4964
Phone: (253) 572-8777
Fax: (253) 572-8835

Authorised official

Name: Glenda Lee Medeen
Title: Business Manager
Phone: (253) 572-8777

Registered specialties

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208G00000X

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Registry record

NPI: 1700902368
Entity type: Organization
NPI issued: 22 Mar 2007
Record last updated: 17 Dec 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.