Provider Demographics
NPI:1972659654
Name:SAYRES, WILLIAM G JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:G
Last Name:SAYRES
Suffix:JR
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 1:4102 S REGAL ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-5083
Mailing Address - Country:US
Mailing Address - Phone:509-535-2277
Mailing Address - Fax:
Practice Address - Street 1:4102 S REGAL ST STE 101
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-5083
Practice Address - Country:US
Practice Address - Phone:509-535-2277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027588207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8133647Medicaid
WAD07825Medicare UPIN
WA8133647Medicaid
WAGAB32558Medicare PIN