Healthcare Provider Details

I. General information

NPI: 1073519328
Provider Name (Legal Business Name): ALBERT DOMINICK PACIFICO II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALBERT DOMINICK PACIFICO M.D.

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 03/20/2025
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11711 NE 12TH STREET SUITE 2B
BELLEVUE WA
98005
US

IV. Provider business mailing address

11711 NE 12TH STREET SUITE 2B
BELLEVUE WA
98005
US

V. Phone/Fax

Practice location:
  • Phone: 425-637-1022
  • Fax: 425-637-2011
Mailing address:
  • Phone: 425-637-1022
  • Fax: 425-637-2011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD00030038
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00030038
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: