Provider Demographics
NPI:1760414510
Name:BIES, WILLIAM RUSSELL (PA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RUSSELL
Last Name:BIES
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:3505 NW ANDERSON HILL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9161
Mailing Address - Country:US
Mailing Address - Phone:360-698-6859
Mailing Address - Fax:253-851-8060
Practice Address - Street 1:4700 POINT FOSDICK DR NW
Practice Address - Street 2:#201
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-851-7733
Practice Address - Fax:253-851-8060
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2020-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA13196363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P20499Medicare UPIN