Healthcare Provider Details

I. General information

NPI: 1053706002
Provider Name (Legal Business Name): ANTHONY MIN WOO YI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 N 45TH ST
SEATTLE WA
98103-6907
US

IV. Provider business mailing address

2409 N 45TH ST
SEATTLE WA
98103-6907
US

V. Phone/Fax

Practice location:
  • Phone: 206-633-8100
  • Fax: 206-633-6107
Mailing address:
  • Phone: 206-633-8100
  • Fax: 206-633-6107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberMD61149499
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD61149499
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: