Provider Demographics
NPI:1154400166
Name:JOANNA B. SLOAN MD
Entity type:Organization
Organization Name:JOANNA B. SLOAN MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:425-899-4300
Mailing Address - Street 1:1515 116TH AVE NE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3811
Mailing Address - Country:US
Mailing Address - Phone:425-899-4300
Mailing Address - Fax:425-688-8850
Practice Address - Street 1:1515 116TH AVE NE
Practice Address - Street 2:SUITE 307
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3811
Practice Address - Country:US
Practice Address - Phone:425-899-4300
Practice Address - Fax:425-688-8850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029104261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center