Healthcare Provider Details

I. General information

NPI: 1053563585
Provider Name (Legal Business Name): ORTHOPEDICS INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BROADWAY STE 460
SEATTLE WA
98122-5312
US

IV. Provider business mailing address

1600 E JEFFERSON ST STE 400
SEATTLE WA
98122-5647
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-0585
  • Fax: 206-709-0148
Mailing address:
  • Phone: 206-323-1900
  • Fax: 206-323-6868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: MARY PAT WHALEY
Title or Position: CHIEF OPERATING OFFICER
Credential: COO
Phone: 206-323-1900