Provider Demographics
NPI:1023095080
Name:ESCHBACH, VIRGINIA (MD)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:ESCHBACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 134TH ST SW
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5322
Mailing Address - Country:US
Mailing Address - Phone:425-297-6200
Mailing Address - Fax:425-297-6250
Practice Address - Street 1:728 134TH ST SW
Practice Address - Street 2:SUITE # 120
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-5322
Practice Address - Country:US
Practice Address - Phone:425-297-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000374642085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA142177OtherL&I PROVIDER NUMBER
WA8242794Medicaid
WA175519OtherL&I PROVIDER NUMBER
WA131141OtherL&I PROVIDER NUMBER
WAG8898478Medicare PIN
WAGAB10679Medicare PIN
WA300106967Medicare UPIN
WA8863846Medicare PIN
WA131141OtherL&I PROVIDER NUMBER
WA8242794Medicaid
WAGAB10678Medicare PIN
WAG88850933Medicare PIN
WA300106968Medicare PIN
WA8857965Medicare PIN