Provider Demographics
NPI:1861413965
Name:SILVA, WILLIAM ANDRE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ANDRE
Last Name:SILVA
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 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:253-681-6626
Mailing Address - Fax:
Practice Address - Street 1:125 N 18TH ST STE A
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3902
Practice Address - Country:US
Practice Address - Phone:605-885-5703
Practice Address - Fax:360-588-5562
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044925207V00000X, 207VG0400X, 208M00000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0307100OtherL&I
1205015112OtherTYPE 2 (GROUP/ORGANIZATIONAL) NPI
WAG8917673OtherMEDICARE PTAN FOR GROUP (ARLINGTON, WA)
WAG8917674OtherMEDICARE PTAN FOR INDIVIDUAL (ARLINGTON, WA)
WA1205015112OtherMEDICAID BILLING PROVIDER #
WA1861413965OtherMEDICAID RENDERING PROVIDER #
WA1020741Medicaid
1861413965OtherTYPE 1 (INDIVIDUAL) NPI
WA2025944OtherPROVIDER ONE # (LINKED TO TYPE 2 NPI)