Healthcare Provider Details

I. General information

NPI: 1497702633
Provider Name (Legal Business Name): TERRENCE JOHN SWEENEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 BROADWAY SWEDISH HOSPITAL MEDICAL CENTER
SEATTLE WA
98122-4379
US

IV. Provider business mailing address

727 17TH AVE E
SEATTLE WA
98112-3921
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-6006
  • Fax: 206-386-3173
Mailing address:
  • Phone: 206-386-6006
  • Fax: 206-386-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD00022953
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: