Healthcare Provider Details

I. General information

NPI: 1508918947
Provider Name (Legal Business Name): EDWARD A. BARKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13751 LAKE CITY WAY NE SUITE 300
SEATTLE WA
98125-8612
US

IV. Provider business mailing address

13751 LAKE CITY WAY NE SUITE 300
SEATTLE WA
98125-8612
US

V. Phone/Fax

Practice location:
  • Phone: 295-623-3814
  • Fax: 206-623-4327
Mailing address:
  • Phone: 295-623-3814
  • Fax: 206-623-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number025209 MD00010688
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: