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General NPI Number Information
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NPI Number | 1386869808
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Entity Type | Organization
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Legal Business Name | HAWTHORNE HILLS INTERNAL MEDICINE PLLC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 4026 NE 55TH ST STE F
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City | SEATTLE
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State | WA
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Zip | 98105-2262
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Country | US
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Telephone | 206-523-9195
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Fax | 206-523-5399
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Provider Business Mailing Address
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Address Line | 4026 NE 55TH ST STE F
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City | SEATTLE
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State | WA
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Zip | 98105-2262
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Country | US
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Telephone | 206-523-9195
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Fax | 206-523-5399
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Authorized Official
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Title or Position | MANAGER
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Name | MS. BARBARA J ROBERTS
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Credential |
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Telephone | 206-523-9195
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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 | MD00020845
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00021170
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License Number State | WA
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