Otis Edd Payne MD

NPI 1114065612 - Psychiatry & Neurology - 2084P0800X

NPI Details
NPI 1114065612
Gender Male
Enumeration Date 02/05/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
21810 76TH AVE WEST
STE 202
EDMONDS WA, 98026, US
Phone (206) 427-2171
Fax (425) 670-8293
Business Location
18015 53RD AVE NE
LAKE FOREST PARK WA, 98155, US
Phone (206) 427-2171
Fax
Toxanomy
Taxonomy Code 2084P0800X
License State Louisiana
License Number MD009959
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According to our database, Otis Edd Payne MD NPI is 1114065612, taxonomy code is 2084P0800X and license number is MD009959, license state is located at Louisiana. Otis Edd Payne MD physically located at 21810 76th Ave West, Edmonds WA, 98026. NPI Number Otis Edd Payne MD has the Individual type.

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1114065612 NPI number is provided on an as is basis without warranty of any kind. 1114065612 is maintained by the National Plan & Provider Enumeration System. The contents of Otis Edd Payne MD are for informational purposes only.