Lois Bresaw MD Inc PS

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD00024914 Issued in WA

Legal business name

LOIS BRESAW MD INC PS

Doing business as

Olympic Gynecology and Women's Care

Practice address

20700 Bond Rd NE BLDG B
Poulsbo, WA 98370-9099

Phone

(360) 697-2199

Fax

(360) 779-5760

NPI assigned

Sep 21, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lois Bresaw, MD

Title

Owner

Phone

(360) 697-2199

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Olympic Gynecology and Women's Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1083600480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20700 BOND RD NE BLDG B",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709099",
            "telephone_number": "360-697-2199",
            "fax_number": "360-779-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20700 BOND RD NE BLDG B",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709099",
            "telephone_number": "360-697-2199",
            "fax_number": "360-779-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOIS BRESAW MD INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "BRESAW",
        "authorized_official_first_name": "LOIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-697-2199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00024914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7076888",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olympic Gynecology and Women's Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.