Provider Demographics
NPI:1811198542
Name:ALLERGY ASTHMA & SINUS CARE CENTER PS
Entity Type:Organization
Organization Name:ALLERGY ASTHMA & SINUS CARE CENTER PS
Other - Org Name:FILIZ MILLIK MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FILIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-698-2500
Mailing Address - Street 1:10049 KITSAP MALL BLVD NW
Mailing Address - Street 2:265
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8903
Mailing Address - Country:US
Mailing Address - Phone:360-698-2500
Mailing Address - Fax:360-698-7788
Practice Address - Street 1:10049 KITSAP MALL BLVD NW
Practice Address - Street 2:265
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8903
Practice Address - Country:US
Practice Address - Phone:360-698-2500
Practice Address - Fax:360-698-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041501174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1123850Medicaid
WA1548247067OtherNPI
WAMD00041501OtherWA STATE LICENSE
WAMD00041501OtherWA STATE LICENSE