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General NPI Number Information
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NPI Number | 1699140426
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Entity Type | Organization
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Legal Business Name | TRENT L TREDWAY MD
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Dates
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Enumeration Date | 12/04/2015
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Last Update Date | 01/24/2016
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Provider Practice Location Address
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Address Line | 901 BOREN AVE STE 600
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City | SEATTLE
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State | WA
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Zip | 98104-3596
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Country | US
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Telephone | 206-799-2132
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Fax |
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Provider Business Mailing Address
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Address Line | 901 BOREN AVE STE 600
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City | SEATTLE
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State | WA
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Zip | 98104-3596
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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 | OWNER
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Name | DR. TRENT L TREDWAY
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Credential | M.D.
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Telephone | 206-799-2132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 603-563-792
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License Number State | WA
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