1932169729 NPI number — DR. MICHAEL J SAILER M.D.

Table of content: DR. MICHAEL J SAILER M.D. (NPI 1932169729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932169729 NPI number — DR. MICHAEL J SAILER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAILER
Provider First Name:
MICHAEL
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1932169729
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 8TH AVE NE STE 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ISSAQUAH
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98029-5436
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-455-3600
Provider Business Mailing Address Fax Number:
425-455-3920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 8TH AVE NE STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ISSAQUAH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98029-5436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-392-3030
Provider Business Practice Location Address Fax Number:
425-392-2564
Provider Enumeration Date:
03/24/2006

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: 207X00000X , with the licence number:  MD00027596 , 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: G8854594 . This is a "MEDICARE EMRI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0045408 . This is a "L & I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: G8861209 . This is a "MEDICARE POSM" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 200018552 . This is a "MEDICARE RR KING CO." identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com