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General NPI Number Information
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NPI Number | 1336152180
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Entity Type | Individual
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Provider Name | KEITH T PAIGE MD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 1100 9TH AVE
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City | SEATTLE
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State | WA
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Zip | 98101-2756
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Country | US
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Telephone | 206-223-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 OLIVE WAY MSC M4-PA
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City | SEATTLE
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State | WA
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Zip | 98101-1873
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Country | US
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Telephone |
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD00036238
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License Number State | WA
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