Healthcare Provider Details

I. General information

NPI: 1780510495
Provider Name (Legal Business Name): SIRION SEWELL
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3444 34TH AVE W
SEATTLE WA
98199-1608
US

IV. Provider business mailing address

3444 34TH AVE W
SEATTLE WA
98199-1608
US

V. Phone/Fax

Practice location:
  • Phone: 206-222-1189
  • Fax:
Mailing address:
  • Phone: 253-222-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: