Healthcare Provider Details

I. General information

NPI: 1770624397
Provider Name (Legal Business Name): RAFAEL A ESCRIBANO JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N 115TH ST NORTHWEST HOSPITAL
SEATTLE WA
98113-9733
US

IV. Provider business mailing address

PO BOX 84858
SEATTLE WA
98124-6158
US

V. Phone/Fax

Practice location:
  • Phone: 318-388-1946
  • Fax:
Mailing address:
  • Phone: 425-407-1000
  • Fax: 425-407-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD00030284
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number77261
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD0940212
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberM.D.09402R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: