Healthcare Provider Details

I. General information

NPI: 1740040120
Provider Name (Legal Business Name): WEST SOUND HEART CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 NW MYHRE PL STE 225
SILVERDALE WA
98383-8562
US

IV. Provider business mailing address

8762 NE WINSLOW GROVE CT
BAINBRIDGE ISLAND WA
98110-5296
US

V. Phone/Fax

Practice location:
  • Phone: 206-290-2718
  • Fax:
Mailing address:
  • Phone: 206-290-2718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHAN MICHAEL RUE SEGERSON
Title or Position: OWNER
Credential: MD
Phone: 206-290-2718