Provider Demographics
NPI:1720668585
Name:FILLIPPA, EMERSON CURTIS (DO)
Entity type:Individual
Prefix:
First Name:EMERSON
Middle Name:CURTIS
Last Name:FILLIPPA
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 1:446 PATAHA ST
Mailing Address - Street 2:
Mailing Address - City:POMEROY
Mailing Address - State:WA
Mailing Address - Zip Code:99347-8634
Mailing Address - Country:US
Mailing Address - Phone:509-843-1491
Mailing Address - Fax:
Practice Address - Street 1:446 PATAHA ST
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:WA
Practice Address - Zip Code:99347-8634
Practice Address - Country:US
Practice Address - Phone:509-843-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAOP61550390207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program