Provider Demographics
NPI:1992797534
Name:PAI, LINDA (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:PAI
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 1:11511 CANTERWOOD BLVD NW
Mailing Address - Street 2:STE 300
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-5820
Mailing Address - Country:US
Mailing Address - Phone:253-530-2940
Mailing Address - Fax:253-530-2945
Practice Address - Street 1:11511 CANTERWOOD BLVD NW
Practice Address - Street 2:STE 300
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5820
Practice Address - Country:US
Practice Address - Phone:253-530-2940
Practice Address - Fax:253-530-2945
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101290208600000X
WAMD60113850208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208885012Medicaid
WA0258250OtherSTATE L&I
MOMA1029002Medicare PIN
WAG8888493Medicare PIN
WA0258250OtherSTATE L&I
MOC187868Medicare ID - Type Unspecified