Healthcare Provider Details

I. General information

NPI: 1417985052
Provider Name (Legal Business Name): NORTHWEST HOSPITAL DBA CHAU SU OU MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10330 MERIDIAN AVE N SUITE 372
SEATTLE WA
98133-9451
US

IV. Provider business mailing address

10330 MERIDIAN AVE N SUITE 372
SEATTLE WA
98133-9451
US

V. Phone/Fax

Practice location:
  • Phone: 206-368-6175
  • Fax: 206-368-6121
Mailing address:
  • Phone: 206-368-6175
  • Fax: 206-368-6121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD00019674
License Number StateWA

VIII. Authorized Official

Name: MR. WILLIAM C SCHNEIDER
Title or Position: PRESIDENT CEO
Credential:
Phone: 206-364-0500