Healthcare Provider Details

I. General information

NPI: 1710203203
Provider Name (Legal Business Name): MATTHEW WADE COTTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2841 NW 61ST ST
SEATTLE WA
98107-2511
US

IV. Provider business mailing address

2841 NW 61ST ST
SEATTLE WA
98107-2511
US

V. Phone/Fax

Practice location:
  • Phone: 512-699-4552
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number60503474
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP-0036657
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: