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General NPI Number Information
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NPI Number | 1093705337
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Entity Type | Individual
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Provider Name | JAMES D PISTER MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 03/10/2017
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Provider Practice Location Address
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Address Line | 1911 SW CAMPUS DR. #107
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City | FEDERAL WAY
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State | WA
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Zip | 98023
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Country | US
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Telephone | 253-839-0170
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Fax |
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Provider Business Mailing Address
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Address Line | 1911 SW CAMPUS DR # 107
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City | FEDERAL WAY
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State | WA
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Zip | 98023-6473
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 1493
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD00017852
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD00017825
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License Number State | WA
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