Healthcare Provider Details

I. General information

NPI: 1306377833
Provider Name (Legal Business Name): RAND MICHAEL DADASOVICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MINOR AVE STE 300
SEATTLE WA
98104-2133
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
84125-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-838-9582
  • Fax: 206-752-1383
Mailing address:
  • Phone: 206-320-4476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD70104912
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: