BROADWAY FOOT & ANKLE PS (NPI# 1265470678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265470678 |
| Entity Type | Organization |
| Organization Name | BROADWAY FOOT & ANKLE PS |
| Practice Address |
6625 W Crest View Loop Se Snoqualmie WA 98065-8912 |
| Mailing Address |
Po Box 24963 Seattle WA 98124-0963 |
| Practice Telephone | 4253965424 |
| Mailing Telephone | 2063204476 |
| Mailing Fax Number | 2063205340 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2008-06-25 |
| Authorized Official Name | DR. BARRY L LICHTER (SOLE PROPRIETOR) |
| Authorized Official Telephone | 2063862800 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WASHINGTON LABOR & INDUSTRY | 193384900 | 01 |
| Street Address |
6625 W CREST VIEW LOOP SE |
| City | SNOQUALMIE |
| State | WA |
| Zip Code | 98065-8912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891265807 | Adam Kutzner | Dentist | 34929 Se Ridge Street Suite 220, Snoqualmie, WA 98065 | 2018-12-03 |
| 1396215000 | Anna Maher | Counselor | 37624 Se Fury St Ste 203, Snoqualmie, WA 98065 | 2018-11-26 |
| 1194271718 | Cindy Costa | Specialist | 38579 Se River Street, Suite 13, Snoqualmie, WA 98065 | 2016-09-01 |
| 1548716830 | Snoqualmie Family Dentistry | Clinic/Center | 38475 Se River Street, Snoqualmie, WA 98065 | 2016-08-28 |
| 1851769202 | Greg Kiper | Counselor | 9571 Ethan Wade Way Se, Snoqualmie, WA 98065 | 2015-09-02 |
| 1952792814 | Casi Davis | Registered Nurse | 8476 Se Reinig Pl, Snoqualmie, WA 98065 | 2015-02-13 |
| 1336484443 | Heidi Biddle | Counselor | 7972 Maple Ave. Se, Snoqualmie, WA 98065 | 2012-11-29 |
| 1255675302 | Patricia Soderlund Holladay | Occupational Therapist | 8001 Silva Ave Se, Snoqualmie, WA 98065 | 2012-11-15 |
| 1750635066 | Anne Elizabeth Mcgavran | Registered Nurse | 8001 Silva Avenue South East, Snoqualmie, WA 98065 | 2012-11-08 |
| 1447552005 | Friends of Youth | Community/Behavioral Health | 7972 Maple Ave. Se., Snoqualmie, WA 98065 | 2010-12-02 |
| Find all providers in zip 98065 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649708819 | Theresa H.t. Nguyen Pllc | Podiatrist | 17530 Ne Union Hill Rd Ste 110, Redmond, WA 98052-3340 | 2017-05-31 |
| 1366749095 | Rapha Clinics, Inc | Podiatrist | 1130 N 185th St Ste 202, Shoreline, WA 98133-4011 | 2011-02-15 |
| 1568673895 | Victoria Kovacs Penfield | Podiatrist | 15717 136th Avenue Ct E, Puyallup, WA 98374-9688 | 2007-05-25 |
| 1922122811 | Randall S. Fisher | Podiatrist | 8610 Eastview Ave, Everett, WA 98208-3516 | 2007-03-18 |
| 1689732588 | Hugh James Gorey Jr. | Podiatrist | 12001 Pacific Ave S., #204, Tacoma, WA 98444-5101 | 2006-12-04 |
| 1134154032 | Stephen Haggard | Podiatrist | 210 27th Ave Apt F105, Milton, WA 98354-8330 | 2006-07-11 |
| 1063493559 | Randolph Charles Fish | Podiatrist | 915 So. 76th St., Tacoma, WA 98408-2902 | 2005-11-10 |
| 1982694501 | Michael Aziz Mishalanie | Podiatrist | 401 S 43rd St, Suite 110, Renton, WA 98055-5404 | 2005-10-25 |
| 1942206891 | Brent Barker | Podiatrist | 18007 Ne 26th St, Vancouver, WA 98684-0735 | 2005-06-24 |
| 1720083652 | John Yohan Joo | Podiatrist | 1130 N 185th St, Suite 200, Shoreline, WA 98133-4011 | 2005-06-16 |
| Find all providers with the same taxonomy | ||||
| City | SNOQUALMIE |
| Zip Code | 98065 |
Please comment or provide details below to improve the information on BROADWAY FOOT & ANKLE PS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.