Individual
INGELA PEZZOLESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9398 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8505
(360) 782-3200
(360) 782-3242
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383
(360) 782-3200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00035255
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080121832
RAILROAD MEDICARE
—
01
—
121701
LABOR & INDUSTRIES
WA
01
—
5035653
AETNA
—
05
—
8224776
—
WA
01
—
8928302
CRIME VICTIMS COMP
WA
01
—
TH4159
REGENCE BLUE SHIELD
—
Enumeration date
06/29/2006
Last updated
03/07/2023
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