Provider Demographics
NPI:1528000155
Name:SOUND UROLOGICAL ASSOCIATES P.S.
Entity Type:Organization
Organization Name:SOUND UROLOGICAL ASSOCIATES P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-670-8950
Mailing Address - Street 1:21822 76TH AVE W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7900
Mailing Address - Country:US
Mailing Address - Phone:425-775-7166
Mailing Address - Fax:425-672-8844
Practice Address - Street 1:21822 76TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7900
Practice Address - Country:US
Practice Address - Phone:425-775-7166
Practice Address - Fax:425-672-8844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA50C0001173261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA490004506OtherRAILROAD MEDICARE
WA490004506OtherRAILROAD MEDICARE