Provider Demographics
NPI:1821107178
Name:NAVIAUX, NILS WARD (MD)
Entity Type:Individual
Prefix:DR
First Name:NILS
Middle Name:WARD
Last Name:NAVIAUX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S 336TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6328
Mailing Address - Country:US
Mailing Address - Phone:253-838-6180
Mailing Address - Fax:253-838-6418
Practice Address - Street 1:2901 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1851
Practice Address - Country:US
Practice Address - Phone:360-738-6788
Practice Address - Fax:360-738-6724
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00047160207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1314NAOtherBSWA
WA5371NAOtherBSWA
WA0218176OtherLIWA
WA3075NAOtherBSWA
WA8291NAOtherBSWA
WA8466054Medicaid
WA0222650OtherLIWA
WA0222651OtherLIWA
CO44687087Medicaid
WA5957NAOtherBSWA
WA8291NAOtherBSWA
WA5957NAOtherBSWA
WA5371NAOtherBSWA
WA3075NAOtherBSWA
WAG8863324Medicare PIN
WA0222650OtherLIWA