MEDICARE: DR. VANESSA FELICIANO M.D.

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	207Q00000X	Family Medicine Physician	MD60217403	WA

General Provider Information

NPI Number	:	1063447365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VANESSA FELICIANO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 34703
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9650 15TH AVE SW STE 100
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98106-2576
Country	:	US
Telephone Number	:	206-965-1000
Fax Number	:	206-965-1001

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	01/19/2023

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