Provider Demographics
NPI:1235419003
Name:OSTEOPATHIC MEDICAL SERVICES INC PS
Entity Type:Organization
Organization Name:OSTEOPATHIC MEDICAL SERVICES INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:425-432-4554
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:22520 SE 218TH ST
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-8001
Practice Address - Country:US
Practice Address - Phone:425-432-4554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSTEOPATHIC MEDICAL SERVICES INC PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site