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General NPI Number Information
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NPI Number | 1184245128
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Entity Type | Individual
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Provider Name | MAXWELL HIRSH MD
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Gender | Male
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 747 BROADWAY
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City | SEATTLE
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State | WA
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Zip | 98122-4379
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Country | US
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Telephone | 206-386-2550
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Fax |
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Provider Business Mailing Address
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Address Line | 18154 SIENA DR
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-3250
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Country | US
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Telephone | 503-853-3504
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 61579872
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License Number State | WA
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