Provider Demographics
NPI:1497168256
Name:SOUND CLINICAL MEDICINE PS
Entity Type:Organization
Organization Name:SOUND CLINICAL MEDICINE PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MENEFEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-857-6166
Mailing Address - Street 1:6718 144TH ST NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8738
Mailing Address - Country:US
Mailing Address - Phone:253-857-6166
Mailing Address - Fax:253-851-6333
Practice Address - Street 1:6718 144TH ST NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8738
Practice Address - Country:US
Practice Address - Phone:253-857-6166
Practice Address - Fax:253-851-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028466174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty