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General NPI Number Information
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NPI Number | 1679991087
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Entity Type | Organization
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Legal Business Name | SEATTLE INFECTIOUS DISEASE CLINIC PLLC
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 1420A 25TH AVE
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City | SEATTLE
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State | WA
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Zip | 98122-3016
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Country | US
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Telephone | 206-329-0338
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24303
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City | SEATTLE
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State | WA
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Zip | 98124-0303
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Country | US
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Telephone | 203-329-0338
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. WARREN L DINGES
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Credential | MD, PHD
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Telephone | 206-329-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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