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General NPI Number Information
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NPI Number | 1487317954
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Entity Type | Organization
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Legal Business Name | 600 STEWART MEDICAL GROUP, P.C.
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 224 WESTLAKE AVE N STE 100
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City | SEATTLE
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State | WA
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Zip | 98109-5260
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Country | US
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Telephone | 206-690-5962
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Fax |
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Provider Business Mailing Address
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Address Line | 224 WESTLAKE AVE N STE 100
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City | SEATTLE
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State | WA
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Zip | 98109-5260
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Country | US
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Telephone | 206-690-5962
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Fax | 855-459-3020
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MARIA A. WISE
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Credential | DO
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Telephone | 206-690-5962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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