Provider Demographics
NPI:1528450434
Name:EYLAN HEALTH INC., P.S.
Entity type:Organization
Organization Name:EYLAN HEALTH INC., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:ADELYNE
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:425-867-9700
Mailing Address - Street 1:15446 BEL RED RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5501
Mailing Address - Country:US
Mailing Address - Phone:425-867-9700
Mailing Address - Fax:425-867-5300
Practice Address - Street 1:15446 BEL RED RD
Practice Address - Street 2:SUITE 320
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5501
Practice Address - Country:US
Practice Address - Phone:425-867-9700
Practice Address - Fax:425-867-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60393547207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOP60393947OtherWA STATE MEDICAL LICENCE