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General NPI Number Information
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NPI Number | 1043639065
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Entity Type | Individual
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Provider Name | COLIN ARNOLD RAELSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 751 NE BLAKELY DR STE 3020
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City | ISSAQUAH
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State | WA
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Zip | 98029-6201
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Country | US
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Telephone | 206-861-8550
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Fax | 206-861-8551
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Provider Business Mailing Address
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Address Line | PO BOX 25608
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City | SALT LAKE CITY
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State | UT
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Zip | 84125-0608
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Country | US
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Telephone | 206-320-4476
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Fax | 206-568-7043
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | MD61317426
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License Number State | WA
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