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General NPI Number Information
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NPI Number | 1588616080
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Entity Type | Organization
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Legal Business Name | DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF WASHINGTON PC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 16233 SYLVESTER RD SW SUITE 250
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City | BURIEN
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State | WA
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Zip | 98166-3045
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Country | US
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Telephone | 206-935-5423
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Fax | 206-935-5469
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Provider Business Mailing Address
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Address Line | PO BOX 60000 FILE #74521
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City | SAN FRANCISCO
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State | CA
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Zip | 94160-0001
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Country | US
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Telephone | 303-626-6234
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Fax | 866-302-6807
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Authorized Official
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Title or Position | OWNER PRESIDENT SECRETARY & TREASUR
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Name | MR. ANTHONY EFTHIM GABRIEL
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Credential | MD
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Telephone | 800-310-4872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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