Healthcare Provider Details

I. General information

NPI: 1811984396
Provider Name (Legal Business Name): ROBERT E LIEPPMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BROADWAY STE 511
SEATTLE WA
98122-4396
US

IV. Provider business mailing address

PO BOX 3489
SEATTLE WA
98114-3489
US

V. Phone/Fax

Practice location:
  • Phone: 206-292-2200
  • Fax: 206-292-7967
Mailing address:
  • Phone: 206-386-9500
  • Fax: 206-386-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD00015463
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: