Provider Demographics
NPI:1578618708
Name:BARRALL, JANET L (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:BARRALL
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 1:2100 LITTLE MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-8752
Mailing Address - Country:US
Mailing Address - Phone:360-416-6735
Mailing Address - Fax:360-424-6954
Practice Address - Street 1:2100 LITTLE MOUNTAIN LN
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-8752
Practice Address - Country:US
Practice Address - Phone:360-416-6735
Practice Address - Fax:360-424-6954
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2018-11-07
Deactivation Date:2017-03-15
Deactivation Code:
Reactivation Date:2018-11-07
Provider Licenses
StateLicense IDTaxonomies
WAMD00029999207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WABA4117OtherBLUE SHIELD #
WAUS4468416OtherAETNA SPECIALIST PIN
WA1088384Medicaid
WA0039593OtherLABOR AND INDUSTRIES #
WABA4117OtherBLUE SHIELD #
WA1088384Medicaid
WAUS4468416OtherAETNA SPECIALIST PIN