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General NPI Number Information
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NPI Number | 1689683229
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Entity Type | Organization
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Legal Business Name | EASTSIDE EMERGENCY PHYSICIANS PLLC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 751 NE BLAKELY DR
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City | ISSAQUAH
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State | WA
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Zip | 98029-6201
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Country | US
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Telephone | 425-313-4000
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Fax | 626-447-6057
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Provider Business Mailing Address
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Address Line | PO BOX 2138
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City | SPOKANE
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State | WA
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Zip | 99210-2138
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Country | US
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Telephone | 800-962-3303
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Fax | 305-929-0770
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | NEIMEH SHALASH
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Credential |
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Telephone | 206-351-3261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | WA
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