Provider Demographics
NPI:1245940212
Name:SALMERON, ISAAC ((R)(RT)(CT)(ARRT))
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:SALMERON
Suffix:
Gender:M
Credentials:(R)(RT)(CT)(ARRT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 TRUMPETER WAY
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-7207
Mailing Address - Country:US
Mailing Address - Phone:915-328-1162
Mailing Address - Fax:
Practice Address - Street 1:222 TRUMPETER WAY
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-7207
Practice Address - Country:US
Practice Address - Phone:915-328-1162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10027942085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUDWW740495692OtherREGENCE UMP