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Organization

ISSAQUAH INTERNAL MEDICINE ASSOCIATES, PLLC

Active
Other names
Vicki Rouillard M.D.
Organization subpart
No

Provider details

NPI number
Authorized official
VICKI M ROUILLARD M.D. (MD)
(425) 391-0313
Entity
Organization

Contact information

Practice address
450 NW GILMAN BLVD STE 301A, ISSAQUAH, WA 98027
(425) 391-0313
(425) 837-8501
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
123345
DEPT OF LABOR AND INDUSTR
WA
05
7090491
WA
01
CN9619
RAILROAD MEDICARE
Enumeration date
01/18/2006
Last updated
05/31/2011
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