Provider Demographics
NPI:1942242508
Name:COYNE, WILLIAM H (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:COYNE
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 1:330 S STILLAGUAMISH AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1642
Mailing Address - Country:US
Mailing Address - Phone:360-435-2133
Mailing Address - Fax:360-435-0513
Practice Address - Street 1:330 S STILLAGUAMISH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1642
Practice Address - Country:US
Practice Address - Phone:360-435-2133
Practice Address - Fax:360-435-0513
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1067297Medicaid
WA1067297Medicaid
WAG8856830Medicare PIN