Healthcare Provider Details

I. General information

NPI: 1578727319
Provider Name (Legal Business Name): LOUISE BERKOWICZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON SUITE 200
SEATTLE WA
98104
US

IV. Provider business mailing address

1101 MADISON SWEDISH PAIN AND HEADACHE CENTER SUITE 200
SEATTLE WA
98104
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-2013
  • Fax:
Mailing address:
  • Phone: 206-386-2013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License NumberMD00040194
License Number StateWA

VIII. Authorized Official

Name: LOUISE BERKOWICZ
Title or Position: PROPRIETER
Credential: M.D.
Phone: 206-386-2013