Healthcare Provider Details

I. General information

NPI: 1104185073
Provider Name (Legal Business Name): NORTHWEST ENT ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 N 115TH ST SUITE 340
SEATTLE WA
98133-8400
US

IV. Provider business mailing address

1536 N 115TH ST SUITE 340
SEATTLE WA
98133-8400
US

V. Phone/Fax

Practice location:
  • Phone: 206-525-2525
  • Fax: 206-525-0346
Mailing address:
  • Phone: 206-525-2525
  • Fax: 206-525-0346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SARAH POLLARD
Title or Position: ADMINISTRATOR
Credential:
Phone: 206-368-1676