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Mario Natale Ponticello, DPM
Foot & Ankle Surgery Podiatrist in Tacoma, Washington
NPI 1134395734

Mario Natale Ponticello is a Foot & Ankle Surgery Podiatrist based in Tacoma, WA and is specialized in Foot & Ankle Surgery. Mario Natale Ponticello practices in Tacoma, WA and has the professional credentials of DPM. The NPI Number for Mario Natale Ponticello is 1134395734 and holds a License No. 950-25 (Washington).

The current practice location address for Mario Natale Ponticello is 9040 Jackson Ave, Tacoma, WA and can be reached out via phone at 253-968-3505. You can also correspond with Mario Natale Ponticello through the mailing address at 9040 JACKSON AVE, TACOMA, WA - 98431-0001 (mailing address contact number: 253-968-3505).

Location: 9040 Jackson Ave, Tacoma, WA, 98431-0001
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Provider Profile Details
NPI Number
1134395734
Provider Name
Mario Natale Ponticello
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
9040 Jackson Ave, Tacoma, WA, 98431-0001
Phone Number
253-968-3505
Fax Number
Provider Enumeration Date
05/03/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P00695367 01 WI RAIL ROAD MEDICARE
43244600 05 WI
institution
Provider Business Practice Location Address Details
Address
9040 Jackson Ave
City
State
Zip
98431-0001
Phone Number
253-968-3505
Fax Number
person
Provider Business Mailing Address Details
Address
9040 Jackson Ave
City
State
Zip
98431-0001
Phone Number
253-968-3505
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
950-25 (Wisconsin)
Definition
Definition to come...
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