Provider Demographics
NPI:1033110309
Name:TARANOW, WARREN S (DO)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:S
Last Name:TARANOW
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:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-5096
Mailing Address - Country:US
Mailing Address - Phone:360-733-2092
Mailing Address - Fax:360-733-4013
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-733-2092
Practice Address - Fax:360-733-4013
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIWT009964207X00000X
PAOS008481L207X00000X
WAOP00002156207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8466740Medicaid
WA0215108OtherL&I AND CRIME VICTIMS
WA5481TAOtherREGENCE
WAP00383024OtherRAILROAD MEDICARE
WA4634420OtherAETNA
WA1033110309Medicaid
WA0215108OtherL&I AND CRIME VICTIMS
WAG8862493Medicare PIN