1275720831 NPI number — PAULUS D TSAI MD PS

Table of content: (NPI 1275720831)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275720831 NPI number — PAULUS D TSAI MD PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAULUS D TSAI MD PS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275720831
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2196
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEQUIM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98382-2196
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-461-3636
Provider Business Mailing Address Fax Number:
360-683-6488

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
530 BOGACHIEL WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORKS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98331-9120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-374-6998
Provider Business Practice Location Address Fax Number:
360-374-3162
Provider Enumeration Date:
09/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TSAI
Authorized Official First Name:
PAULUS
Authorized Official Middle Name:
DARCY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
360-461-3636

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  MD00043281 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8807671 . This is a "MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1120831 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8408445 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: G8807669 . This is a "MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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