1710164918 NPI number — MINOR & JAMES MEDICAL PLLC

Table of content: (NPI 1710164918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710164918 NPI number — MINOR & JAMES MEDICAL PLLC

Organization/Personal Information

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'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:
1710164918
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 MINOR AVE
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98104-2120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-386-9500
Provider Business Mailing Address Fax Number:
206-576-3802

Provider's Practice Location Mailing Address

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:
206-576-3802
Provider Enumeration Date:
01/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
STEART
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
206-386-9500

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , 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)

  • Identifier: 5891740001 . This is a "DME FH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 78900 . This is a "LABOR & INDUSTRY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7136872 . This is a "MEDICAID / AUDIOLOGY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: CE1300 . This is a "PALMETTO / RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0008864538 . This is a "MEDICARE / FHSC" 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: 7139439 . This is a "MEDICAID / FHSC" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1548250012 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7022544 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7027352 . This is a "MEDICAID / ASC ENDO UNIT" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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