Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Mark D Nellermoe Professional Service Corporation

Organization Podiatrist · NPI 1194145094

Mark D Nellermoe Professional Service Corporation provides Podiatrist services in University Place, Washington. Licensed in Washington. Registered with an NPI since 2014.

Licensed in
WA
In the registry since
2014

Practice location Address checks out

3929 Bridgeport Way W Ste 308
University Place, WA 98466-4455
Phone: (253) 627-4181
Fax: (253) 272-5922
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence PO00000507 (WA)

Record details

NPI number1194145094
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Nellermoe — Owner · (253) 627-4181
NPI enumeratedApril 18, 2014
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025
Mailing address3929 Bridgeport Way W Ste 308, University Place, WA 98466-4455

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