Provider Demographics
NPI:1487662581
Name:COLE, ALLISON M (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:COLE
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 1:1410 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1720
Mailing Address - Country:US
Mailing Address - Phone:425-258-1830
Mailing Address - Fax:425-258-1353
Practice Address - Street 1:1410 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1720
Practice Address - Country:US
Practice Address - Phone:425-258-1830
Practice Address - Fax:425-258-1353
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044943207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8433781Medicaid
WA8907040OtherCRIME VICTIMS
WA200256OtherLABOR AND INDUSTRIES
WAI40572Medicare UPIN
WA8855683Medicare ID - Type Unspecified