Provider Demographics
NPI:1871518639
Name:LIBERTY BAY INTERNAL MEDICINE ASSOCIATES INC PS
Entity type:Organization
Organization Name:LIBERTY BAY INTERNAL MEDICINE ASSOCIATES INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NARINDER
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUGGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-779-9911
Mailing Address - Street 1:20700 BOND RD NE
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-9099
Mailing Address - Country:US
Mailing Address - Phone:360-779-9911
Mailing Address - Fax:360-779-9971
Practice Address - Street 1:20700 BOND RD NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-9099
Practice Address - Country:US
Practice Address - Phone:360-779-9911
Practice Address - Fax:360-779-9971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00036603207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty