Healthcare Provider Details

I. General information

NPI: 1831456466
Provider Name (Legal Business Name): CRAIG SZELA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 N 45TH ST
SEATTLE WA
98103-6701
US

IV. Provider business mailing address

1629 N 45TH ST
SEATTLE WA
98103-6701
US

V. Phone/Fax

Practice location:
  • Phone: 206-563-3335
  • Fax: 206-633-3133
Mailing address:
  • Phone: 206-563-3335
  • Fax: 206-633-3133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number60611366
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: