Provider Demographics
NPI:1821143595
Name:BILNOSKI, BILLY COY (MD)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:COY
Last Name:BILNOSKI
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 1:1802 YAKIMA AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5305
Mailing Address - Country:US
Mailing Address - Phone:253-627-1244
Mailing Address - Fax:253-985-2868
Practice Address - Street 1:1802 YAKIMA AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4499
Practice Address - Country:US
Practice Address - Phone:253-627-1244
Practice Address - Fax:253-627-6576
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD0022247174400000X
WAMD00022247207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4754BIOtherREGENCE
WA1802BIOtherREGENCE
WA1708BIOtherREGENCE
WA8600116Medicaid
WA205976OtherDEPARTMENT OF L&I
WA1130BIOtherREGENCE
WA060070343OtherRAILROAD MEDICARE
WA1019876Medicaid
WA1801BIOtherREGENCE
WA205976OtherDEPARTMENT OF L&I