Provider Demographics
NPI:1962438325
Name:ATTAWAY, NOLA (MD)
Entity type:Individual
Prefix:
First Name:NOLA
Middle Name:
Last Name:ATTAWAY
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 1:4540 SAND POINT WAY NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3941
Mailing Address - Country:US
Mailing Address - Phone:206-527-1200
Mailing Address - Fax:206-523-0724
Practice Address - Street 1:3901 CREEKSIDE LOOP
Practice Address - Street 2:SUITE 100
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4801
Practice Address - Country:US
Practice Address - Phone:509-966-3259
Practice Address - Fax:509-966-0191
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036860207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8235822Medicaid
WA030004278OtherRAILROAD MEDICARE YAKIMA
WA030004267OtherRAILROAD MEDICARE RICHLAND
WA030004278OtherRAILROAD MEDICARE YAKIMA
WAAB06491Medicare ID - Type Unspecified