Provider Demographics
NPI:1962663773
Name:ABILMONA, FAUZIA ASHLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:FAUZIA
Middle Name:ASHLEY
Last Name:ABILMONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:A
Other - Last Name:ABILMONA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11315 BRIDGEPORT WAY SW
Mailing Address - Street 2:FRANCISCAN ANESTHESIA ASSOCIATES
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3004
Mailing Address - Country:US
Mailing Address - Phone:716-622-3755
Mailing Address - Fax:
Practice Address - Street 1:11315 BRIDGEPORT WAY SW
Practice Address - Street 2:FRANCISCAN ANESTHESIA ASSOCIATES
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3004
Practice Address - Country:US
Practice Address - Phone:716-622-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110102207L00000X
WAMD60295789207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0300145OtherLABOR AND INDUSTRY
MT1962663773OtherDSHS MONTANA
WAP01121115OtherRAILROAD MEDICARE
WA2022441Medicaid
WAP01121115OtherRAILROAD MEDICARE