Healthcare Provider Details
I. General information
NPI: 1447518220
Provider Name (Legal Business Name): PRIYA RAJENDRA MOTZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/30/2012
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
HARBORVIEW MEDICAL CENTER 325 9TH AVE
SEATTLE WA
98195
US
IV. Provider business mailing address
20200 54TH AVENUE W
LYNNWOOD WA
98036-6389
US
V. Phone/Fax
- Phone: 206-744-3261
- Fax:
- Phone: 425-672-6400
- Fax: 425-672-6518
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | OP60652667 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | OP60652667 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: