Provider Demographics
NPI:1215940325
Name:ROMANO, ALLAN J (MD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:J
Last Name:ROMANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4746
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4746
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1374
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000265082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8120388Medicaid
WA218041OtherL&I PROVIDER ID
WA218042OtherL&I PROVIDER ID
WA6535ROOtherREGENCE
WA218044OtherL&I PROVIDER ID
WAG8864384Medicare PIN
WAG8864138Medicare PIN
WA218044OtherL&I PROVIDER ID
WAP00447722Medicare PIN
WA6535ROOtherREGENCE
WAG8864383Medicare PIN
WAG8864140Medicare PIN