Healthcare Provider Details

I. General information

NPI: 1760444897
Provider Name (Legal Business Name): RAY Y SATO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MARTIN LUTHER KING JR WAY MS Z0-NTL
TACOMA WA
98405-4234
US

IV. Provider business mailing address

2000 ALASKAN WAY SUITE 349
SEATTLE WA
98121-2198
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-1019
  • Fax: 253-403-1686
Mailing address:
  • Phone: 206-728-1792
  • Fax: 253-403-1686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number33781
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: