Healthcare Provider Details

I. General information

NPI: 1093337354
Provider Name (Legal Business Name): YAIEL G. RODRIGUEZ-AVILES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2020
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON ST
SEATTLE WA
98104-1306
US

IV. Provider business mailing address

PO BOX 837
QUEBRADILLAS PR
00678-0837
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-6800
  • Fax:
Mailing address:
  • Phone: 787-840-2575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number6219094
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: