Provider Demographics
NPI:1821045972
Name:POLLARA, TRISHA LEE (MD)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:LEE
Last Name:POLLARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3600 LIND AVE SW
Mailing Address - Street 2:STE 100
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4934
Mailing Address - Country:US
Mailing Address - Phone:425-656-5412
Mailing Address - Fax:425-656-4079
Practice Address - Street 1:7203 129TH AVE SE
Practice Address - Street 2:STE 200
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98056-1412
Practice Address - Country:US
Practice Address - Phone:425-656-5428
Practice Address - Fax:425-656-5427
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00045602207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8860457Medicare PIN