Provider Demographics
NPI:1740988294
Name:EMBER MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:EMBER MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:ABRAHAMSON
Authorized Official - Last Name:LAFORTEZA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:253-394-6933
Mailing Address - Street 1:929 E MAIN STE 230
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3116
Mailing Address - Country:US
Mailing Address - Phone:253-394-6933
Mailing Address - Fax:
Practice Address - Street 1:929 E MAIN STE 230
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3116
Practice Address - Country:US
Practice Address - Phone:253-862-3026
Practice Address - Fax:877-474-7412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty