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NPI Code Detail

MEDICARE: SEAN THOMAS ATTERIDGE DO

MEDICARE: SEAN THOMAS ATTERIDGE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOP00000803WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
277101OTHERWALABOR INDUSTRIES

General Provider Information

NPI Number : 1326082520
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN THOMAS ATTERIDGE DO
Provider Business Mailing Address
First Line : 150 DENNIS ST SW
Second Line :
City : TUMWATER
State : WA
Zip : 98501-5459
Country : US
Telephone Number : 360-754-6367
Fax Number : 360-754-6429
Provider Business Practice Location Address
First Line : 150 DENNIS ST SW
Second Line :
City : TUMWATER
State : WA
Zip : 98501-5459
Country : US
Telephone Number : 360-754-6367
Fax Number : 360-754-6429
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 07/08/2007

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Directions to “ SEAN THOMAS ATTERIDGE DO” Practice Location

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