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Organization

EASTSIDE PULMONARY ASSOCIATES INC PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BARRY LYON MARMORSTEIN M.D. (PHYSICIAN)
(425) 761-6401
Entity
Organization

Contact information

Practice address
919 109TH AVE NE, BELLEVUE, WA 98004-4485
(425) 646-3993
(425) 453-8274
Mailing address
PO BOX 88, RONALD, WA 98940-0088
(425) 761-6401
(509) 674-6896

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD00013991
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014435
LABOR & INDUSTRIES
WA
01
336277300
FEDERAL DEPT OF LABOR
WA
01
5558MA
REGENCE BLUE SHIELD
WA
05
7123961
WA
01
8921640
L&I CRIME VICTIMS UNIT
WA
01
M123
REGENCE BLUE SHIELD
WA
Enumeration date
06/07/2007
Last updated
01/03/2012
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