Healthcare Provider Details

I. General information

NPI: 1457463424
Provider Name (Legal Business Name): MATTHEW PATTERSON KRONMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE SEATTLE CHILDREN'S HOSPITAL
SEATTLE WA
98105
US

IV. Provider business mailing address

4800 SAND POINT WAY NE SEATTLE CHILDREN'S HOSPITAL
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2073
  • Fax: 206-985-3121
Mailing address:
  • Phone: 206-987-2073
  • Fax: 206-985-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD431696
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00046267
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberMD00046267
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: