Provider Demographics
NPI:1831166354
Name:TACOMA HYPERBARIC BILLING, LLC
Entity type:Organization
Organization Name:TACOMA HYPERBARIC BILLING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER LLC
Authorized Official - Prefix:
Authorized Official - First Name:RAHEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SADIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-223-9333
Mailing Address - Street 1:PO BOX 64992
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98464-0992
Mailing Address - Country:US
Mailing Address - Phone:253-535-0140
Mailing Address - Fax:253-537-4184
Practice Address - Street 1:1717 SO J ST
Practice Address - Street 2:ST JOSEPH MEDICAL CENTER- HYPERBARIC UNIT & WOUND CLINI
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-627-4101
Practice Address - Fax:253-426-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037438207PE0005X, 207R00000X
WA6020699052083P0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7106768Medicaid
WA=========OtherGROUP HEALTH
WA=========OtherMOLINA
WA=========OtherUNIFORM MEDICAL PLAN
WA=========OtherTRICARE
WA=========OtherPACIFICARE/SECURE HORIZON
WA=========OtherRAILROAD MEDICARE
WA=========OtherFIRST CHOICE HEALTH PLANS
WA7106768Medicaid
WA=========OtherAETNA INSURANCE
WA=========OtherREGENCE BLUE SHIELD
WA=========OtherUNITED HEALTHCARE
WA=========OtherWA LABOR & INDUSTRIES
WA=========OtherKITSAP HEALTH PLANS
WA=========OtherPREMERA
WAAB22393Medicare ID - Type UnspecifiedMEDICARE GROUP