Individual
CHRISTINE AGBAYANI LOMOTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 POTTERY AVE, PORT ORCHARD, WA 98366-3711
(360) 895-5000
Mailing address
1400 POTTERY AVE, PORT ORCHARD, WA 98366-3711
(360) 895-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00030451
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129072
STATE L & I
WA
01
—
0224704
STATE L & I
WA
01
—
0227446
STATE L & I
WA
01
—
0255580
STATE L & I
WA
01
—
MD30451
WA STATE LICENSE
WA
Enumeration date
09/04/2006
Last updated
04/28/2021
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