Healthcare Provider Details

I. General information

NPI: 1558417964
Provider Name (Legal Business Name): ORTHOPEDICS INTERNATIONAL LTD PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BROADWAY SUITE 460
SEATTLE WA
98122-5312
US

IV. Provider business mailing address

901 BOREN AVE SUITE 800
SEATTLE WA
98104-3534
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-0585
  • Fax: 206-324-6925
Mailing address:
  • Phone: 206-329-0585
  • Fax: 206-324-6925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCO N WEN
Title or Position: PRESIDENT
Credential: MD
Phone: 206-329-0585