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Individual

GEORGE L DOLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4011 TALBOT ROAD SOUTH, SUITE 500, RENTON, WA 98055
(425) 251-5110
(425) 793-7376
Mailing address
PO BOX 59028, RENTON, WA 98058-2028
(425) 251-5110
(425) 793-7458

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD00023180
WA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD00023180
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0111626
L&I
WA
01
110138451
RR MEDICARE
WA
05
8107757
WA
Enumeration date
10/25/2006
Last updated
01/22/2010
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