Healthcare Provider Details

I. General information

NPI: 1992269567
Provider Name (Legal Business Name): MICHAEL JOSEPH SALTERS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SW HOLDEN ST
SEATTLE WA
98126-3505
US

IV. Provider business mailing address

925 SENECA ST H10NS
SEATTLE WA
98101-2742
US

V. Phone/Fax

Practice location:
  • Phone: 206-248-8226
  • Fax:
Mailing address:
  • Phone: 206-624-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License NumberRN60897611
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: