MEDICARE: MICHAEL MEASOM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MD61568655	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013598184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MEASOM MD

Provider Business Mailing Address
First Line	:	6214 27TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-7114
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	MAIN HOSPITAL 1959 NE PACIFIC ST 2ND FLOOR
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-0001
Country	:	US
Telephone Number	:	206-598-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	01/12/2026

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