Individual
PAUL BAGNULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7315 212TH ST SW, SUITE 101, EDMONDS, WA 98026-7610
(425) 775-9474
Mailing address
7315 212TH ST SW, SUITE 101, EDMONDS, WA 98026-7610
(425) 775-9474
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00013875
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1069400
—
WA
Enumeration date
09/28/2006
Last updated
02/05/2014
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