Individual
MICHAEL J. NAILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Mailing address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(360) 636-2400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00046545
WA
207R00000X
Internal Medicine Physician
MD25719
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210529
LABOR & IND.
WA
05
—
026536
—
OR
05
—
8455321
—
WA
01
—
8941878
CRIME VICITMS
WA
01
—
P00330654
RR MEDICARE
—
Enumeration date
05/24/2006
Last updated
02/04/2022
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