Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 11897 | OR |
NPI | 1023291374 |
---|---|
Provider Name | Dr. Paul M Puziss |
First Address | Beaverton, OR 97005-4760 |
Second Address | Beaverton, OR 97005-4760 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2007 |
Last Update Date | 16/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000573000 | REGENCE BCBS (01) | OR |
0022446 | WA DEPT LABOR & INDUSTRY (01) | WA |
058412 | (05) | OR |
194400600 | OWCP (01) | WA |
C93569 | (02) | OR |