Healthcare Provider Details

I. General information

NPI: 1841343019
Provider Name (Legal Business Name): LILA M DAY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 W TAPPS DR E
LAKE TAPPS WA
98391-9176
US

IV. Provider business mailing address

3920 W TAPPS DR E
LAKE TAPPS WA
98391-9176
US

V. Phone/Fax

Practice location:
  • Phone: 253-862-8001
  • Fax: 253-826-4792
Mailing address:
  • Phone: 253-862-8001
  • Fax: 253-826-4792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00036049
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: