Healthcare Provider Details

I. General information

NPI: 1205258647
Provider Name (Legal Business Name): NATALIE LIAT ROSENWASSER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIE LIAT ROSENWASSER M.D.

II. Dates (important events)

Enumeration Date: 01/18/2014
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ROOSEVELT WAY NE
SEATTLE WA
98105-4718
US

IV. Provider business mailing address

430 E 63RD ST APT 7D
NEW YORK NY
10065
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2835
  • Fax:
Mailing address:
  • Phone: 914-906-0280
  • 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 Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number60953302
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: