1851508683 NPI number — MRS. FAINA PULVERMAKHER SPAETH ARNP

Table of content: MRS. FAINA PULVERMAKHER SPAETH ARNP (NPI 1851508683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851508683 NPI number — MRS. FAINA PULVERMAKHER SPAETH ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPAETH
Provider First Name:
FAINA
Provider Middle Name:
PULVERMAKHER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PULVERMAKHER
Provider Other First Name:
FAINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1851508683
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 16TH AVE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98112-5226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-326-3490
Provider Business Mailing Address Fax Number:
206-326-3391

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 16TH AVE E
Provider Second Line Business Practice Location Address:
CMB, RADIATION ONCOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98112-5226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-326-4951
Provider Business Practice Location Address Fax Number:
206-326-3391
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  AP30007667 , 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)





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