Provider Demographics
NPI:1891721635
Name:RICE, PRESTON ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:ANDREW
Last Name:RICE
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 1:9621 RIDGETOP BLVD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:360-782-3689
Practice Address - Street 1:2200 NW MYHRE RD
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7681
Practice Address - Country:US
Practice Address - Phone:360-830-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027214207YS0123X, 207YX0007X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
4510963OtherAETNA
WA8117863Medicaid
RI6563OtherREGENCE BLUESHIELD
040002989OtherRAILROAD MEDICARE
WA8913531OtherCRIME VICTIM COMP
WA75445OtherLABOR & INDUSTRIES
WA75445OtherLABOR & INDUSTRIES
WAG000250626Medicare PIN
WA75445OtherLABOR & INDUSTRIES
WAGAB05206Medicare PIN
E72429Medicare UPIN
G8899955Medicare PIN
040002989OtherRAILROAD MEDICARE
G8899956Medicare PIN
BR0274922OtherDEA
WA8913531OtherCRIME VICTIM COMP
4510963OtherAETNA
G8887536Medicare PIN