1548250012 NPI number — MINOR & JAMES MEDICAL PLLC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548250012 NPI number — MINOR & JAMES MEDICAL PLLC

Employer Identification Number (EIN):

Provider Organization Name:

MINOR & JAMES MEDICAL PLLC

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1548250012

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

12/01/2014

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 26947

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SALT LAKE CITY

Provider Business Mailing Address State Name:

UT

Provider Business Mailing Address Postal Code:

84126-0947

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

206-386-9500

Provider Business Mailing Address Fax Number:

206-386-9605

Provider First Line Business Practice Location Address:

515 MINOR AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SEATTLE

Provider Business Practice Location Address State Name:

WA

Provider Business Practice Location Address Postal Code:

98104-2120

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

206-386-9500

Provider Business Practice Location Address Fax Number:

206-386-9605

Provider Enumeration Date:

10/26/2005

Authorized Official Last Name:

MARTIN

Authorized Official First Name:

JAMES

Authorized Official Middle Name:

C

Authorized Official Title or Position:

CMO

Authorized Official Telephone Number:

206-386-9500

• Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 7136872 . This is a "AUDIOLOGY MEDICAID" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 7139439 . This is a "MEDICARE ASC/FHSC" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 144182 . This is a "L&I LABORATORY" identifier . This identifiers is of the category "OTHER".
• Identifier: 7027352 . This is a "MEDICAID ASC" identifier . This identifiers is of the category "OTHER".
• Identifier: 9060666 . This is a "MEDICAID HEARING AIDS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 501034 . This is a "MEDICARE/ASC CERT" identifier . This identifiers is of the category "OTHER".
• Identifier: 5891740001 . This is a "DME" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 7022544 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: 215831 . This is a "L&I ASC/FHSC" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 163569 . This is a "L&I ASC" identifier . This identifiers is of the category "OTHER".
• Identifier: 8901651 . This is a "L&I CRIME VICTIMS" identifier . This identifiers is of the category "OTHER".
• Identifier: 78900 . This is a "LI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: CE1300 . This is a "PALMETTA GBA /RR MEDICARE" identifier . This identifiers is of the category "OTHER".