Provider Demographics
NPI:1770640815
Name:ORMSBY, ALICE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:MARIE
Last Name:ORMSBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11800 NE 128TH ST
Mailing Address - Street 2:STE 450
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7211
Mailing Address - Country:US
Mailing Address - Phone:425-899-3376
Mailing Address - Fax:425-899-4131
Practice Address - Street 1:12333 NE 130TH LN STE 330
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7467
Practice Address - Country:US
Practice Address - Phone:425-899-3376
Practice Address - Fax:425-899-4131
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026006207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE53803Medicare UPIN
GAB32193Medicare PIN