Healthcare Provider Details

I. General information

NPI: 1235300500
Provider Name (Legal Business Name): CONSTANTINE W. PALASKAS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MADISON ST STE 1410
SEATTLE WA
98104-3555
US

IV. Provider business mailing address

1570 WEST ARMORY WAY STE 101 PMB # 105
SEATTLE WA
98119-2678
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-8088
  • Fax:
Mailing address:
  • Phone: 206-486-8088
  • Fax: 206-971-1656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberMD00022586
License Number StateWA

VIII. Authorized Official

Name: CONSTANTINE W PALASKAS
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 206-486-8088