Provider Demographics
NPI:1073519328
Name:PACIFICO, ALBERT DOMINICK II (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:DOMINICK
Last Name:PACIFICO
Suffix:II
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ALBERT
Other - Middle Name:DOMINICK
Other - Last Name:PACIFICO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11711 NE 12TH STREET
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005
Mailing Address - Country:US
Mailing Address - Phone:425-637-1022
Mailing Address - Fax:425-637-2011
Practice Address - Street 1:11711 NE 12TH STREET
Practice Address - Street 2:SUITE 2B
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005
Practice Address - Country:US
Practice Address - Phone:425-637-1022
Practice Address - Fax:425-637-2011
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030038207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1042731Medicaid
WA8150468Medicaid
WAF58145Medicare UPIN
WAAB21341Medicare ID - Type Unspecified
WA1042731Medicaid