Provider Demographics
NPI:1407925043
Name:SIMNAD, VIRGINIA I (MD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:I
Last Name:SIMNAD
Suffix:
Gender:F
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:PO BOX 34036
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1036
Mailing Address - Country:US
Mailing Address - Phone:425-899-3270
Mailing Address - Fax:425-899-3269
Practice Address - Street 1:12039 NE 128TH ST
Practice Address - Street 2:300
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3030
Practice Address - Country:US
Practice Address - Phone:425-899-5350
Practice Address - Fax:425-899-5355
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD600709492084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8538712Medicaid
WA8538712Medicaid