Healthcare Provider Details

I. General information

NPI: 1225196215
Provider Name (Legal Business Name): JOHN FLINT DICKSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 BELLEVUE AVE EAST #401
SEATLLE WA
98102-5990
US

IV. Provider business mailing address

714 BELLEVUE AVE EAST #401
SEATTLE WA
98102-5990
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-6216
  • Fax:
Mailing address:
  • Phone: 206-329-6216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number11653
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: