1790861458 NPI number — PATRICIA GALE READ-WILLIAMS

Table of content: PATRICIA GALE READ-WILLIAMS (NPI 1790861458)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790861458 NPI number — PATRICIA GALE READ-WILLIAMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
READ-WILLIAMS
Provider First Name:
PATRICIA
Provider Middle Name:
GALE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1790861458
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 50095
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:
98145-5095
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-543-6420
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PICKERING PLACE
Provider Second Line Business Practice Location Address:
1455 11TH AVE NW
Provider Business Practice Location Address City Name:
ISSAQUAH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-391-3900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2006

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: 207Q00000X , with the licence number:  MD00023837 , 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: 1790861458 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 77180 . This is a "INTERNAL ID-MOTOR VEHICLE ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0152686 . This is a "L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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