Healthcare Provider Details

I. General information

NPI: 1801871074
Provider Name (Legal Business Name): ARUNAS T BANIONIS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2005
Last Update Date: 03/07/2023
Certification Date: 02/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9398 RIDGETOP BLVD NW
SILVERDALE WA
98383-8505
US

IV. Provider business mailing address

9621 RIDGETOP BLVD NW
SILVERDALE WA
98383-8502
US

V. Phone/Fax

Practice location:
  • Phone: 360-782-3200
  • Fax: 360-782-3240
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOP00001793
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP00001793
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: