Provider Demographics
NPI:1649453184
Name:TORRES, EDWARD (LMP)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 562
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-0562
Mailing Address - Country:US
Mailing Address - Phone:425-793-7505
Mailing Address - Fax:425-793-8224
Practice Address - Street 1:321 BURNETT AVE S
Practice Address - Street 2:SUITE 306
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2558
Practice Address - Country:US
Practice Address - Phone:425-793-7505
Practice Address - Fax:425-793-8224
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA18364174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist