Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | MD00023585 | WA |
NPI | 1033191531 |
---|---|
Provider Name | Dr. Krystyna Izabella Pilecki |
First Address | Seattle, WA 98124-1036 |
Second Address | Valencia, CA 91355-4467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 09/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010063771 | MEDICARE RAILROAD (01) | WA |
136718 | LABOR & INDUSTRIES (01) | WA |
5621PI | BLUE SHIELD (01) | WA |
8143083 | (05) | WA |
E21715 | (02) | WA |