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General NPI Number Information
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NPI Number | 1619666237
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Entity Type | Organization
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Legal Business Name | NORTHWEST SURGICAL OF BELLEVUE
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 636 120TH AVE NE STE A204
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City | BELLEVUE
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State | WA
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Zip | 98005-3087
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Country | US
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Telephone | 425-307-3546
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Fax |
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Provider Business Mailing Address
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Address Line | 10849 EMERALD CHASE DR
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City | ORLANDO
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State | FL
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Zip | 32836-5881
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WALTER MICHAEL SWEENEY II
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Credential | MD
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Telephone | 312-965-0963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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