Provider Demographics
NPI:1487650883
Name:FIGUEROA, EDGAR A (MD)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:A
Last Name:FIGUEROA
Suffix:
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:PO BOX 1529
Mailing Address - Street 2:905 EAST D STREET
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-1529
Mailing Address - Country:US
Mailing Address - Phone:509-276-5005
Mailing Address - Fax:509-276-7785
Practice Address - Street 1:905 E D STREET
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:WA
Practice Address - Zip Code:99006
Practice Address - Country:US
Practice Address - Phone:509-276-5005
Practice Address - Fax:509-276-7785
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018431207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA124535OtherL&I
WA8309569Medicaid
WA8309569Medicaid
WAGAB06080Medicare PIN