Provider Demographics
NPI:1720258981
Name:SOUND INTERNAL MEDICINE INC
Entity type:Organization
Organization Name:SOUND INTERNAL MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-841-2401
Mailing Address - Street 1:34716 1ST AVE S
Mailing Address - Street 2:#A
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6760
Mailing Address - Country:US
Mailing Address - Phone:253-838-1898
Mailing Address - Fax:
Practice Address - Street 1:34716 1ST AVE S
Practice Address - Street 2:#A
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6760
Practice Address - Country:US
Practice Address - Phone:253-838-1898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028366207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1123736Medicaid
WAF26964Medicare UPIN
WAGAB26411Medicare PIN