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Individual

EDWARD DY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
23213 PACIFIC HWY S, KENT, WA 98032-2721
(206) 870-8880
(206) 520-1499
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00048928
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0236942
L&I
WA
05
1790771947
WA
01
P00524189
RAILROAD MEDICARE
WA
Enumeration date
09/23/2005
Last updated
09/19/2012
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