Provider Demographics
NPI:1679193205
Name:SOUND VASCULAR, P.S.
Entity Type:Organization
Organization Name:SOUND VASCULAR, P.S.
Other - Org Name:SOUND VASCULAR ASC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-854-4523
Mailing Address - Street 1:32014 32ND AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98001-9625
Mailing Address - Country:US
Mailing Address - Phone:253-874-7107
Mailing Address - Fax:
Practice Address - Street 1:32014 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98001-9625
Practice Address - Country:US
Practice Address - Phone:253-874-7107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUND VASCULAR, P.S.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-23
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty