Provider Demographics
NPI:1245237536
Name:LOMBARD, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:LOMBARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 BIRCHWOOD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1783
Mailing Address - Country:US
Mailing Address - Phone:360-734-9233
Mailing Address - Fax:360-738-8974
Practice Address - Street 1:410 BIRCHWOOD AVE
Practice Address - Street 2:STE 200
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1783
Practice Address - Country:US
Practice Address - Phone:360-734-9233
Practice Address - Fax:360-738-8974
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019275174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1806801Medicaid
WAA09534Medicare UPIN