Fodczuk, Spencer Laine

Fodczuk, Spencer Laine is an individual health care provider with primary practice located at 3908 10Th St Se , Puyallup WA 98374-2188. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Fodczuk, Spencer Laine can be contacted via phone (253) 848-5951.

Contact Information

Primary practice address
3908 10Th St Se Puyallup WA 98374-2188
Phone: (253) 848-5951
Fax: (253) 845-7073
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60344476 Washington

Profile Details

NPI number 1831253145
LBN Legal business name Fodczuk, Spencer Laine
Credentials MPAS, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2006
Last updated Jan 25th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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