Ponraj, Edson Gerry
Ponraj, Edson Gerry is an individual health care provider with primary practice located at 11315 Bridgeport Way Sw , Lakewood WA 98499-3004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Ponraj, Edson Gerry can be contacted via phone (253) 589-8700.Contact Information
Primary practice address
11315 Bridgeport Way Sw
Lakewood WA 98499-3004
Phone: (253) 589-8700
Fax: (253) 581-6588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD00043988 | Washington |
Profile Details
| NPI number | 1396783940 |
|---|---|
| LBN Legal business name | Ponraj, Edson Gerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2006 |
| Last updated | Mar 5th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396783940 | NPPES |
| Washington | Other | 1186PO | BSWA |
| Washington | MEDICAID | 8400749 | BSWA |
| Washington | Other | 0186779 | BSWA |
| Washington | Other | 0186778 | BSWA |
| Washington | Other | 2165PO | BSWA |
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