Provider Demographics
NPI:1952970980
Name:AXIOS MEDICAL GROUP, PLLC
Entity Type:Organization
Organization Name:AXIOS MEDICAL GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENE-STROESCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-302-6039
Mailing Address - Street 1:3212 50TH ST CT STE 103
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-445-2385
Mailing Address - Fax:253-445-0384
Practice Address - Street 1:3212 50TH ST CT STE 103
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:253-445-2385
Practice Address - Fax:253-445-0384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty