Healthcare Provider Details

I. General information

NPI: 1225354848
Provider Name (Legal Business Name): PHILIP D WELCH M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BROADWAY STE 628
SEATTLE WA
98122-4396
US

IV. Provider business mailing address

801 BROADWAY STE 628
SEATTLE WA
98122-4396
US

V. Phone/Fax

Practice location:
  • Phone: 206-622-1055
  • Fax: 206-215-6566
Mailing address:
  • Phone: 206-622-1055
  • Fax: 206-215-6566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD00018862
License Number StateWA

VIII. Authorized Official

Name: PHILIP D WELCH
Title or Position: OWNER
Credential: M.D.
Phone: 206-622-1055