Provider Demographics
NPI:1164748224
Name:POLL, WILLIAM JOHN (LMP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOHN
Last Name:POLL
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 EASTLAKE AVE E
Mailing Address - Street 2:SUITE 360
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3143
Mailing Address - Country:US
Mailing Address - Phone:206-324-8600
Mailing Address - Fax:
Practice Address - Street 1:2722 EASTLAKE AVE E
Practice Address - Street 2:SUITE 360
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3143
Practice Address - Country:US
Practice Address - Phone:206-324-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60004130225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist