Basic Information
| Provider Information | |||||||||
| NPI: | 1972509933 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TROYER | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | JON HEADINGS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., C.M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 747 BROADWAY | ||||||||
| Address2: | #WW-A11B | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981224379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063171956 | ||||||||
| FaxNumber: | 2063207195 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 8TH AVE S | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067883700 | ||||||||
| FaxNumber: | 2063207195 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2005 | ||||||||
| LastUpdateDate: | 06/10/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | MD 39087 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | MD 39087 | 01 | WA | STATE MEDICAL LICENSE | OTHER |