Healthcare Provider Details

I. General information

NPI: 1831360627
Provider Name (Legal Business Name): NORTH SEATTLE PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10330 MERIDIAN AVE N SUITE 210
SEATTLE WA
98133
US

IV. Provider business mailing address

10330 MERIDIAN AVE N SUITE 210
SEATTLE WA
98133
US

V. Phone/Fax

Practice location:
  • Phone: 206-368-6080
  • Fax: 206-368-6088
Mailing address:
  • Phone: 206-368-6080
  • Fax: 206-368-6088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VINITA SERU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 206-368-6080