1548434749 NPI number — INPATIENT PHYSICAN SERVICES PLLC

Table of content: (NPI 1548434749)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548434749 NPI number — INPATIENT PHYSICAN SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INPATIENT PHYSICAN SERVICES 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's Other Name Information

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 Information

NPI Number:
1548434749
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10618 NE 155TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOTHELL
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98011-5770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-437-2549
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1334 TERRY 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:
98101-2747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-922-6500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MATHEWS
Authorized Official First Name:
ROY
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
206-437-2549

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  OP00001488 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com