Basic Information
| Provider Information | |||||||||
| NPI: | 1104923655 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTSOUND ORTHOPAEDICS, PS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4409 NW ANDERSON HILL RD | ||||||||
| Address2: | |||||||||
| City: | SILVERDALE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983836807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606986300 | ||||||||
| FaxNumber: | 3606987002 | ||||||||
| Practice Location | |||||||||
| Address1: | 4409 NW ANDERSON HILL RD | ||||||||
| Address2: | |||||||||
| City: | SILVERDALE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983836807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606986300 | ||||||||
| FaxNumber: | 3606987002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2006 | ||||||||
| LastUpdateDate: | 12/13/2007 | ||||||||
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| AuthorizedOfficialLastName: | BLISS | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3606986630 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 7128614 | 05 | WA | MEDICAID | DD9486 | 01 | WA | RAILROAD MEDICARE | OTHER | 0199369 | 01 | WA | LABOR AND INDUSTRIES | OTHER | 912037200 | 01 | WA | OWCP | OTHER |