Provider Demographics
NPI:1699007260
Name:PULMONARY RESPIRATORY EXPERT PHYSICIANS, PLLC
Entity Type:Organization
Organization Name:PULMONARY RESPIRATORY EXPERT PHYSICIANS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-842-2379
Mailing Address - Street 1:7068 WING POINT RD NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2987
Mailing Address - Country:US
Mailing Address - Phone:206-842-2379
Mailing Address - Fax:206-842-2379
Practice Address - Street 1:7068 WING POINT RD NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2987
Practice Address - Country:US
Practice Address - Phone:206-842-2379
Practice Address - Fax:206-842-2379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044635207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAI37330Medicare UPIN