Healthcare Provider Details

I. General information

NPI: 1497647366
Provider Name (Legal Business Name): MARCO MATEO GUERRERO RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N 115TH ST MAIN HOSPITAL
SEATTLE WA
98133
US

IV. Provider business mailing address

1550 N 115TH ST MAIN HOSPITAL
SEATTLE WA
98133
US

V. Phone/Fax

Practice location:
  • Phone: 206-265-3065
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License NumberLR61386735
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: