Healthcare Provider Details

I. General information

NPI: 1912067331
Provider Name (Legal Business Name): RALPH A PASCUALY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 17TH AVE STE A20
SEATTLE WA
98122-5788
US

IV. Provider business mailing address

PO BOX 84026
SEATTLE WA
98124-8426
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-4744
  • Fax: 206-215-1135
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberMD00017526
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: