Provider Demographics
NPI:1851580427
Name:WASHINGTON EM-I MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:WASHINGTON EM-I MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ISCOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-563-3010
Mailing Address - Street 1:3916 STATE ST
Mailing Address - Street 2:#300
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5602
Mailing Address - Country:US
Mailing Address - Phone:805-563-3010
Mailing Address - Fax:805-564-5087
Practice Address - Street 1:502 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-1616
Practice Address - Country:US
Practice Address - Phone:509-865-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADD8096OtherRAILROAD
WA8854685Medicare PIN