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NPI Code Detail

MEDICARE: MATTHIAS PARK

MEDICARE: MATTHIAS PARK
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
1207P00000XEmergency Medicine PhysicianMD.MD.70105382WA

General Provider Information

NPI Number : 1033868658
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHIAS PARK
Provider Business Mailing Address
First Line : 4800 SAND POINT WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98105-3901
Country : US
Telephone Number : 206-987-2000
Fax Number :
Provider Business Practice Location Address
First Line : 4800 SAND POINT WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98105-3901
Country : US
Telephone Number : 206-987-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2022
Last Update Date : 05/31/2026

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Directions to “ MATTHIAS PARK ” Practice Location

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