Healthcare Provider Details

I. General information

NPI: 1952543217
Provider Name (Legal Business Name): SEATTLE SPINE INSTITUTE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 11/20/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH AVE SUITE 404
SEATTLE WA
98122-5699
US

IV. Provider business mailing address

550 16TH AVE SUITE 404
SEATTLE WA
98122-5699
US

V. Phone/Fax

Practice location:
  • Phone: 206-322-1765
  • Fax: 206-322-1785
Mailing address:
  • Phone: 206-322-1765
  • Fax: 206-322-1785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number00027530
License Number StateWA

VIII. Authorized Official

Name: MR. PAUL E SCHWAEGLER
Title or Position: SURGEON
Credential: M.D.
Phone: 206-322-1765