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1114019049

NPI Code Detail

MEDICARE: LLOYD TURLA LICUANAN MD

MEDICARE: LLOYD TURLA LICUANAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036123174	IL
2	207Q00000X	Family Medicine Physician	T2006017510	MO
3	207Q00000X	Family Medicine Physician	MD61380771	WA

General Provider Information

NPI Number	:	1114019049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LLOYD TURLA LICUANAN MD

Provider Business Mailing Address
First Line	:	1145 BROADWAY
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-4201
Country	:	US
Telephone Number	:	206-860-5414
Fax Number	:

Provider Business Practice Location Address
First Line	:	9709 3RD AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-2062
Country	:	US
Telephone Number	:	206-860-2222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	02/12/2024

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Directions to “ LLOYD TURLA LICUANAN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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