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General NPI Number Information
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NPI Number | 1013135417
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Entity Type | Organization
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Legal Business Name | WESTERN WASHINGTON MEDICAL GROUP
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 1717 13TH ST SUITE 300
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City | EVERETT
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State | WA
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Zip | 98201
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Country | US
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Telephone | 425-297-5500
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Fax | 425-297-5553
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Provider Business Mailing Address
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Address Line | 1717 13TH ST SUITE 300
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City | EVERETT
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State | WA
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Zip | 98201
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Country | US
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Telephone | 425-297-5500
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Fax | 425-297-5553
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Authorized Official
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Title or Position | CEO
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Name | MR. HENRY R VELDMAN
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Credential |
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Telephone | 425-259-4041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | WA
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