Healthcare Provider Details

I. General information

NPI: 1184690240
Provider Name (Legal Business Name): JAMES P GASPARICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MADISON SUITE 1210
SEATTLE WA
98104-1370
US

IV. Provider business mailing address

1221 MADISON SUITE 1210
SEATTLE WA
98104-1370
US

V. Phone/Fax

Practice location:
  • Phone: 206-292-6488
  • Fax: 206-623-2436
Mailing address:
  • Phone: 206-292-6488
  • Fax: 206-623-2436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD00019030
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: