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General NPI Number Information
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NPI Number | 1366597932
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Entity Type | Organization
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Legal Business Name | SEATTLE REPRODUCTIVE MEDICINE
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 1505 WESTLAKE AVE N SUITE 400
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City | SEATTLE
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State | WA
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Zip | 98109-3050
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Country | US
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Telephone | 206-301-5000
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Fax | 206-285-4555
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Provider Business Mailing Address
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Address Line | 1505 WESTLAKE AVE N SUITE 400
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City | SEATTLE
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State | WA
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Zip | 98109-3050
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Country | US
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Telephone | 206-301-5000
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Fax | 206-285-4555
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRAD SENSTRA
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Credential |
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Telephone | 206-301-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0006X
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Taxonomy Name | Ambulatory Fertility Facility
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License Number | 602352899
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State |
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