Healthcare Provider Details

I. General information

NPI: 1033196845
Provider Name (Legal Business Name): ARTURO HERIDA CASTRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 ALASKAN WAY S
SEATTLE WA
98134-1102
US

IV. Provider business mailing address

1519 ALASKAN WAY S
SEATTLE WA
98134-1102
US

V. Phone/Fax

Practice location:
  • Phone: 206-217-6430
  • Fax: 206-217-6636
Mailing address:
  • Phone: 206-217-6430
  • Fax: 206-217-6636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number46897
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: