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General NPI Number Information
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NPI Number | 1952362311
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Entity Type | Individual
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Provider Name | ISAM DORNA MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 401 15TH AVE SE
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City | PUYALLUP
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State | WA
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Zip | 98372-3715
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Country | US
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Telephone | 253-403-4532
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Fax | 253-403-1374
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Provider Business Mailing Address
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Address Line | 315 MARTIN LUTHER KING JR WAY
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City | TACOMA
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State | WA
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Zip | 98405-4234
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Country | US
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Telephone | 534-034-5292
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Fax | 253-301-6529
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD60123479
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | MD60123479
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License Number State | WA
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