Healthcare Provider Details

I. General information

NPI: 1548250012
Provider Name (Legal Business Name): MINOR & JAMES MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 12/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MINOR AVE
SEATTLE WA
98104-2120
US

IV. Provider business mailing address

PO BOX 26947
SALT LAKE CITY UT
84126-0947
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-9500
  • Fax: 206-386-9605
Mailing address:
  • Phone: 206-386-9500
  • Fax: 206-386-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES C MARTIN
Title or Position: CMO
Credential: MD
Phone: 206-386-9500