Basic Information
| Provider Information | |||||||||
| NPI: | 1942281894 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOONEY | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | ROBERT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 48159 | ||||||||
| Address2: | |||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981480159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062441212 | ||||||||
| FaxNumber: | 8665572717 | ||||||||
| Practice Location | |||||||||
| Address1: | 16251 SYLVESTER RD SW | ||||||||
| Address2: | |||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062441212 | ||||||||
| FaxNumber: | 8665572717 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2005 | ||||||||
| LastUpdateDate: | 05/18/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD00020207 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1005792 | 05 | WA | MEDICAID | 0165307 | 01 | WA | DEPT OF LABOR & INDUSTRIE | OTHER | 050091208 | 01 | RAILROAD MEDICARE | OTHER | 5394LO | 01 | WA | REGENCE BLUE SHIELD | OTHER | 8934232 | 01 | WA | CRIME VICTIMS PGM | OTHER |