Healthcare Provider Details

I. General information

NPI: 1982145819
Provider Name (Legal Business Name): MATTHEW CARDINALE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2017
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON ST STE 600
SEATTLE WA
98104-3501
US

IV. Provider business mailing address

1101 MADISON ST STE 600
SEATTLE WA
98104-1340
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-2020
  • Fax: 206-342-6166
Mailing address:
  • Phone: 206-215-2020
  • Fax: 206-342-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOP61207451
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1849
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: