1225237936 NPI number — DR. EMILY CECILE MACDONALD DO, FAAP

Table of content: DR. EMILY CECILE MACDONALD DO, FAAP (NPI 1225237936)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225237936 NPI number — DR. EMILY CECILE MACDONALD DO, FAAP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACDONALD
Provider First Name:
EMILY
Provider Middle Name:
CECILE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO, FAAP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225237936
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22180 OLYMPIC COLLEGE WAY NW, SUITE 203
Provider Second Line Business Mailing Address:
SOUND PEDIATRICS
Provider Business Mailing Address City Name:
POULSBO
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-626-4031
Provider Business Mailing Address Fax Number:
360-626-4037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22180 OLYMPIC COLLEGE WAY NW, SUITE 203
Provider Second Line Business Practice Location Address:
SOUND PEDIATRICS
Provider Business Practice Location Address City Name:
POULSBO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-626-4031
Provider Business Practice Location Address Fax Number:
360-626-4037
Provider Enumeration Date:
07/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  OP60464417 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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