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NPI Code Detail

MEDICARE: JAMES RANDOLPH PEACEY M.D.

MEDICARE: JAMES RANDOLPH PEACEY 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
12084P0804XChild & Adolescent Psychiatry PhysicianMD00027874WA

Other Identifiers

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

General Provider Information

NPI Number : 1134196769
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES RANDOLPH PEACEY M.D.
Provider Business Mailing Address
First Line : 2600 SW HOLDEN ST
Second Line :
City : SEATTLE
State : WA
Zip : 98126-3505
Country : US
Telephone Number : 206-933-7000
Fax Number : 206-933-7101
Provider Business Practice Location Address
First Line : 2600 SW HOLDEN ST
Second Line :
City : SEATTLE
State : WA
Zip : 98126-3505
Country : US
Telephone Number : 206-933-7000
Fax Number : 206-933-7101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 02/18/2016

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