Healthcare Provider Details

I. General information

NPI: 1932178621
Provider Name (Legal Business Name): GARY L FORSTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 216TH ST SW
EDMONDS WA
98026-8006
US

IV. Provider business mailing address

720 OLIVE WAY
SEATTLE WA
98101-1874
US

V. Phone/Fax

Practice location:
  • Phone: 425-673-3900
  • Fax: 425-673-3910
Mailing address:
  • Phone: 206-838-2590
  • Fax: 206-264-8689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD00018042
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: