Healthcare Provider Details

I. General information

NPI: 1225044498
Provider Name (Legal Business Name): WILLIAM J WATTS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 116TH AVE NE SUITE 600
BELLEVUE WA
98004-4623
US

IV. Provider business mailing address

PO BOX 84088
SEATTLE WA
98124-8488
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-2671
  • Fax: 425-990-5261
Mailing address:
  • Phone: 425-454-5281
  • Fax: 425-454-2062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD00017193
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD00017193
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: