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Individual

JOSEPH PELLICER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 491-9480
Mailing address
700 LILLY RD NE, OLYMPIA, WA 98506-5115
(360) 923-7000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00025036
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
168553
WA L &I
05
268750
OR
05
8246910
WA
01
8935581
WA CRIME VICTIMS
01
930111843
RAILROAD
01
A011
CHAMPUS
01
E33368
GROUP HEALTH
01
PE3371
REGENCE BS
Enumeration date
06/16/2006
Last updated
04/28/2021
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