Provider Demographics
NPI:1457471179
Name:EMMONS, WILLIAM FRANK JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANK
Last Name:EMMONS
Suffix:JR
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 1:1401 MARVIN ROAD NE
Mailing Address - Street 2:SUITE 307 PMB 246
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5768
Mailing Address - Country:US
Mailing Address - Phone:360-491-0327
Mailing Address - Fax:
Practice Address - Street 1:8607 FERNWOOD ST NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516
Practice Address - Country:US
Practice Address - Phone:360-491-0327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA13617207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery