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General NPI Number Information
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NPI Number | 1245206200
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Entity Type | Individual
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Provider Name | SETH CHARLES BAGAN MD
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 1355 N. 205TH ST.
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City | SHORELINE
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State | WA
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Zip | 98133
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Country | US
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Telephone | 617-414-2080
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Fax | 617-414-2090
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Provider Business Mailing Address
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Address Line | PO BOX 50095
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City | SEATTLE
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State | WA
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Zip | 98145
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Country | US
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Telephone | 206-543-6420
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00040378
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License Number State | WA
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