1073572095 NPI number — THADDEUS R PAPROCKI MD

Table of content: THADDEUS R PAPROCKI MD (NPI 1073572095)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073572095 NPI number — THADDEUS R PAPROCKI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAPROCKI
Provider First Name:
THADDEUS
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1073572095
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1229 MADISON ST
Provider Second Line Business Mailing Address:
SUITE 900
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98104-3586
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-292-6233
Provider Business Mailing Address Fax Number:
206-292-7764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1550 N 115TH
Provider Second Line Business Practice Location Address:
NORTHWEST HOSPITAL
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-368-1744
Provider Business Practice Location Address Fax Number:
206-368-1398
Provider Enumeration Date:
03/20/2006

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: 2085R0202X , with the licence number:  MD00016722 , 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: 6092PA . This is a "REGENCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 910849248 . This is a "TAX ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300042979 . This is a "RAILROAD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7822109 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8135451 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 55679 . This is a "LI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: WE4663 . This is a "REGENCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 55900 . This is a "LI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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