Provider Demographics
NPI:1275720831
Name:PAULUS D TSAI MD PS
Entity Type:Organization
Organization Name:PAULUS D TSAI MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULUS
Authorized Official - Middle Name:DARCY
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-461-3636
Mailing Address - Street 1:PO BOX 2196
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-2196
Mailing Address - Country:US
Mailing Address - Phone:360-461-3636
Mailing Address - Fax:360-683-6488
Practice Address - Street 1:530 BOGACHIEL WAY
Practice Address - Street 2:
Practice Address - City:FORKS
Practice Address - State:WA
Practice Address - Zip Code:98331-9120
Practice Address - Country:US
Practice Address - Phone:360-374-6998
Practice Address - Fax:360-374-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043281207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8807671OtherMEDICARE
WA1120831Medicaid
WA8408445Medicaid
WAG8807669OtherMEDICARE
WA8408445Medicaid