Provider Demographics
NPI:1942250717
Name:LOMBARDI, WILLIAM LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LOUIS
Last Name:LOMBARDI
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:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-2420
Practice Address - Country:US
Practice Address - Phone:206-598-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039540207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1942250717Medicaid
WA1942250717Medicaid
WA8280323Medicaid
WA1942250717Medicaid
WA8280323Medicaid
AKMD7367Medicaid
WAG8900994OtherMEDICARE PIN FOR PHMG
WAH36240Medicare UPIN
AKMD7367Medicaid
WA0280180OtherL&I AND CRIME VICTIMS FOR PHMG
WAGAB21581Medicare PIN
WA060066497OtherRAILROAD MEDICARE
WA1942250717Medicaid
WA8280323Medicaid