Provider Demographics
NPI:1841860640
Name:RAINIER SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:RAINIER SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:360-761-1285
Mailing Address - Street 1:853 WATSON ST N STE 100
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-3948
Mailing Address - Country:US
Mailing Address - Phone:360-761-1285
Mailing Address - Fax:360-761-1313
Practice Address - Street 1:2820 GRIFFIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2373
Practice Address - Country:US
Practice Address - Phone:360-761-1285
Practice Address - Fax:360-761-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty