Healthcare Provider Details

I. General information

NPI: 1013940170
Provider Name (Legal Business Name): ALLISON J WARMINGTON PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 TALBOT RD S SUITE 530
RENTON WA
98055-5772
US

IV. Provider business mailing address

PO BOX 34876
SEATTLE WA
98124-1876
US

V. Phone/Fax

Practice location:
  • Phone: 425-228-6076
  • Fax: 425-226-5224
Mailing address:
  • Phone: 425-656-5412
  • Fax: 425-656-4096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA10004556
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: