Healthcare Provider Details

I. General information

NPI: 1073572095
Provider Name (Legal Business Name): THADDEUS R PAPROCKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N 115TH NORTHWEST HOSPITAL
SEATTLE WA
98133
US

IV. Provider business mailing address

1229 MADISON ST SUITE 900
SEATTLE WA
98104-3586
US

V. Phone/Fax

Practice location:
  • Phone: 206-368-1744
  • Fax: 206-368-1398
Mailing address:
  • Phone: 206-292-6233
  • Fax: 206-292-7764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD00016722
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: