Provider Demographics
NPI:1750313243
Name:MILNE, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:MILNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:530 WILDERNESS PEAK DR NW
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5621
Mailing Address - Country:US
Mailing Address - Phone:425-427-8139
Mailing Address - Fax:425-233-9204
Practice Address - Street 1:2005 NW SAMMAMISH RD
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5364
Practice Address - Country:US
Practice Address - Phone:425-394-0610
Practice Address - Fax:425-394-0809
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00042149207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8373219Medicaid
WAH69169Medicare UPIN
WA8373219Medicaid