Provider Demographics
NPI:1942281894
Name:LOONEY, TODD ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ROBERT
Last Name:LOONEY
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 48159
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-0159
Mailing Address - Country:US
Mailing Address - Phone:206-244-1212
Mailing Address - Fax:866-557-2717
Practice Address - Street 1:16251 SYLVESTER RD SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3017
Practice Address - Country:US
Practice Address - Phone:206-244-1212
Practice Address - Fax:866-557-2717
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020207207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1005792Medicaid
WA0165307OtherDEPT OF LABOR & INDUSTRIE
050091208OtherRAILROAD MEDICARE
WA5394LOOtherREGENCE BLUE SHIELD
WA8934232OtherCRIME VICTIMS PGM
WA5394LOOtherREGENCE BLUE SHIELD
A05987Medicare UPIN