Provider Demographics
NPI:1154359156
Name:IULIANO, EDWARD M (DO)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:M
Last Name:IULIANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2300
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-2300
Mailing Address - Country:US
Mailing Address - Phone:509-943-5616
Mailing Address - Fax:509-943-9272
Practice Address - Street 1:888 SWIFT BLVD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-943-5616
Practice Address - Fax:509-943-9272
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP000020382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8446411Medicaid
OR240415Medicaid
WA8860483Medicare PIN
WAP00323156Medicare PIN