Individual
LLEWELLYN PHILLIPS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4509 TALBOT RD S, SUITE 200, RENTON, WA 98055-6294
(425) 228-4520
(425) 226-0283
Mailing address
4509 TALBOT RD S, SUITE 200, RENTON, WA 98055-6294
(425) 228-4520
(425) 226-0283
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00013579
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120734144076
PREMERA BLUE CROSS
WA
05
—
1681105
—
WA
01
—
P618
REGENCE BCBS
WA
Enumeration date
08/29/2006
Last updated
10/10/2007
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