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General NPI Number Information
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NPI Number | 1457715039
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Entity Type | Individual
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Provider Name | CALEB GENE VAN ESSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 747 BROADWAY SUITE WW-739
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City | SEATTLE
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State | WA
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Zip | 98122-4307
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Country | US
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Telephone | 206-386-2123
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Fax |
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Provider Business Mailing Address
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Address Line | 7117 S WINDERMERE ST
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City | LITTLETON
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State | CO
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Zip | 80120-4025
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Country | US
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Telephone | 303-903-0735
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0066057
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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