Healthcare Provider Details

I. General information

NPI: 1891028007
Provider Name (Legal Business Name): RICHARD WALTER STEKETEE MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 NW LEARY WAY PATH-MACEPA
SEATTLE WA
98107-5136
US

IV. Provider business mailing address

1455 NW LEARY WAY PATH-MACEPA
SEATTLE WA
98107-5136
US

V. Phone/Fax

Practice location:
  • Phone: 206-285-3500
  • Fax:
Mailing address:
  • Phone: 206-285-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number44454
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: