Healthcare Provider Details

I. General information

NPI: 1528238284
Provider Name (Legal Business Name): KAREN B. VANIVER, MD, FACS, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2008
Last Update Date: 03/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MADISON ST SUITE 1520
SEATTLE WA
98104-3588
US

IV. Provider business mailing address

PO BOX 50150
BELLEVUE WA
98015-0150
US

V. Phone/Fax

Practice location:
  • Phone: 206-292-6226
  • Fax: 206-623-8825
Mailing address:
  • Phone: 425-228-5228
  • Fax: 425-228-5733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMD00045935
License Number StateWA

VIII. Authorized Official

Name: DR. KAREN BETH VANIVER
Title or Position: PRESIDENT
Credential: MD
Phone: 206-292-6226