Provider Demographics
NPI:1932265766
Name:SEARLE, ALAN JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JOHN
Last Name:SEARLE
Suffix:
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 1:10239 LILLEHEI LN SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-9624
Mailing Address - Country:US
Mailing Address - Phone:360-876-3070
Mailing Address - Fax:
Practice Address - Street 1:10239 LILLEHEI LN SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-9624
Practice Address - Country:US
Practice Address - Phone:360-876-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020336207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAF05780Medicare UPIN