Provider Demographics
NPI:1194760611
Name:SIPES, BOBBI A (MD)
Entity type:Individual
Prefix:DR
First Name:BOBBI
Middle Name:A
Last Name:SIPES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407-14TH AVE. SE.
Mailing Address - Street 2:407-14TH AVE. SE, POB 1247
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-0182
Mailing Address - Country:US
Mailing Address - Phone:253-697-1848
Mailing Address - Fax:
Practice Address - Street 1:407 14TH AVE SE
Practice Address - Street 2:407-14TH AVE. SE, POB 1247
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3770
Practice Address - Country:US
Practice Address - Phone:253-697-1848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026430207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8202681Medicaid
WA8801044Medicare PIN
WAD38242Medicare UPIN