Healthcare Provider Details

I. General information

NPI: 1689581696
Provider Name (Legal Business Name): ETHAN HOUSER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 OLIVE WAY STE 1138
SEATTLE WA
98101-1724
US

IV. Provider business mailing address

509 OLIVE WAY STE 1138
SEATTLE WA
98101-1724
US

V. Phone/Fax

Practice location:
  • Phone: 206-813-0201
  • Fax:
Mailing address:
  • Phone: 206-813-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: