Healthcare Provider Details

I. General information

NPI: 1891953097
Provider Name (Legal Business Name): MONIQUE ROCHELLE RADMAN-HARRISON MD, MAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2008
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE # FA.2112
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE # RC.2820
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-4074
  • Fax: 206-987-3866
Mailing address:
  • Phone: 206-987-4074
  • Fax: 206-987-3866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA102330
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number60454608
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: