Individual
VICTORIA M ROUILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
751 NE BLAKELY DR, SUITE 5010, ISSAQUAH, WA 98029-6201
(425) 394-0700
Mailing address
PO BOX 1225, ISSAQUAH, WA 98027-0047
(425) 391-0313
(425) 837-8501
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00032314
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110172085
RAILROAD MEDICARE
—
01
—
121451
DEPT OF LABOR INDUSTRIES
WA
05
—
8231185
—
WA
01
—
RO5577
REGENCE BLUE SHIELD
WA
Enumeration date
01/18/2006
Last updated
06/28/2012
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