MEDICARE: ROGER WINFIELD GRAHAM 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD00021129	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	66863	OTHER	WA ST LABOR INDUSTRIES
2	81407	OTHER	WA ST LABOR INDUSTRIES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245212307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER WINFIELD GRAHAM MD

Provider Business Mailing Address
First Line	:	1737 AIRPORT WAY S STE 200
Second Line	:	QUEST DIAGNOSTICS
City	:	SEATTLE
State	:	WA
Zip	:	98134-1636
Country	:	US
Telephone Number	:	206-623-8100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1737 AIRPORT WAY S STE 200
Second Line	:	QUEST DIAGNOSTICS
City	:	SEATTLE
State	:	WA
Zip	:	98134-1636
Country	:	US
Telephone Number	:	206-623-8100
Fax Number	:

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	05/20/2015

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