Basic Information
Provider Information | |||||||||
NPI: | 1588771984 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ALMY SIMON | ||||||||
FirstName: | MARIA DEL PILAR | ||||||||
MiddleName: | E | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | DPM | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | ALMY | ||||||||
OtherFirstName: | MARIA DEL PILAR | ||||||||
OtherMiddleName: | E | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | DPM | ||||||||
OtherLastNameType: | 2 | ||||||||
Mailing Information | |||||||||
Address1: | 1100 9TH AVE | ||||||||
Address2: | M4-PFS | ||||||||
City: | SEATTLE | ||||||||
State: | WA | ||||||||
PostalCode: | 981012756 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2065155811 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 1100 9TH AVE | ||||||||
Address2: |   | ||||||||
City: | SEATTLE | ||||||||
State: | WA | ||||||||
PostalCode: | 981012756 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2062236600 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/23/2006 | ||||||||
LastUpdateDate: | 02/18/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | PO00000628 | WA | Y |   | Podiatric Medicine & Surgery Service Providers | Podiatrist |   |
ID Information
ID | Type | State | Issuer | Description | US2043076 | 01 | WA | AETNA/USHC SPECIALIST | OTHER | 8235392 | 05 | WA |   | MEDICAID | 0039598 | 01 | WA | LABOR & INDUSTRY | OTHER | PD628WA | 01 | WA | ALASKA MEDICAID | OTHER | 480028933 | 01 |   | RAILROAD MEDICARE | OTHER | AL6115 | 01 | WA | BLUE SHIELD | OTHER |