Provider Demographics
NPI:1336181676
Name:EDMONDS EMERGENCY PHYSICIANS, INC.
Entity Type:Organization
Organization Name:EDMONDS EMERGENCY PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-771-3466
Mailing Address - Street 1:PO BOX 34936
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21601 76TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7508
Practice Address - Country:US
Practice Address - Phone:425-640-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
33580OtherWASHINGTON L&I
8904230OtherWASHINGTON CRIME VICTIMS
WA7758501Medicaid
ED5531OtherBLUE SHIELD
WA7758501Medicaid