MEDICARE: NANCY B ISENBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	MD60229440	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700886157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY B ISENBERG MD

Provider Business Mailing Address
First Line	:	PO BOX 25608
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84125-0608
Country	:	US
Telephone Number	:	206-320-4476
Fax Number	:	206-568-7043

Provider Business Practice Location Address
First Line	:	7320 216TH ST SW STE 310
Second Line	:
City	:	EDMONDS
State	:	WA
Zip	:	98026-8006
Country	:	US
Telephone Number	:	425-673-3800
Fax Number	:	425-673-3803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	03/03/2020

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Directions to “ NANCY B ISENBERG MD” Practice Location

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