Healthcare Provider Details

I. General information

NPI: 1891918553
Provider Name (Legal Business Name): NW REPRODUCTIVE MEDICINE ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12333 NE 130TH LN STE 220
KIRKLAND WA
98034-7467
US

IV. Provider business mailing address

12333 NE 130TH LN STE 220
KIRKLAND WA
98034-7467
US

V. Phone/Fax

Practice location:
  • Phone: 424-284-4400
  • Fax:
Mailing address:
  • Phone: 424-284-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberBUS13698
License Number StateWA

VIII. Authorized Official

Name: KATHERINE A BUFFINGTON
Title or Position: ADMINISTRATIVE
Credential: FACMCPE
Phone: 424-284-4400