MEDICARE: DAVID P POMEROY MD PS

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	MD00015957	WA
2	207Q00000X	Family Medicine Physician	15957	WA

General Provider Information

NPI Number	:	1346235173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID P POMEROY MD PS

Provider Business Mailing Address
First Line	:	2000 116TH AVE NE
Second Line	:	STE 6
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3047
Country	:	US
Telephone Number	:	425-454-8684
Fax Number	:	206-339-5465

Provider Business Practice Location Address
First Line	:	2000 116TH AVE NE
Second Line	:	STE 6
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3047
Country	:	US
Telephone Number	:	425-454-8684
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID P POMEROY
Credential	:	MD
Telephone Number	:	425-454-8684

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	08/22/2020

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