Healthcare Provider Details

I. General information

NPI: 1770575078
Provider Name (Legal Business Name): JOHN RIDER HESS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

PO BOX 50095, SEATTLE, WA 98145
SEATTLE WA
98145
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-6420
  • Fax:
Mailing address:
  • Phone: 206-543-6420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMD00015060
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMD00015060
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: