NPI 1396783940

Edson Gerry Ponraj, MD

Practitioner Emergency Medicine Physician Lakewood, WA

Practice location

Address: 11315 Bridgeport Way SW, Lakewood, WA 98499-3004
Phone: (253) 589-8700
Fax: (253) 581-6588
Mailing address: 505 S 336th St Suite 600, Federal Way, WA 98003-6328

Registered specialties

Emergency Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207P00000X Licence MD00043988 (WA)

Other Emergency Medicine providers in Washington →

Registry record

NPI: 1396783940
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Jun 2006
Record last updated: 5 Mar 2008

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.