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General NPI Number Information
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NPI Number | 1255811048
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Entity Type | Organization
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Legal Business Name | MIKKI SEAGREN PLLC
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 1370 116TH AVE NE STE 106
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City | BELLEVUE
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State | WA
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Zip | 98004-3831
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Country | US
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Telephone | 425-658-2525
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Fax | 646-780-7951
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Provider Business Mailing Address
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Address Line | 10900 NE 4TH ST STE 2300
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City | BELLEVUE
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State | WA
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Zip | 98004-5882
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Country | US
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Telephone | 206-701-5600
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MIKKI SEAGREN
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Credential | DO
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Telephone | 425-241-6632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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