MEDICARE: DR. PAUL H DREYFUSS 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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	MD00040561	WA
2	208VP0014X	Interventional Pain Medicine Physician	MD00040561	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
2	153759	OTHER	WA	L&I #

General Provider Information

NPI Number	:	1306817481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL H DREYFUSS MD

Provider Business Mailing Address
First Line	:	PO BOX 34036
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1036
Country	:	US
Telephone Number	:	425-899-3292
Fax Number	:	425-899-3269

Provider Business Practice Location Address
First Line	:	11800 NE 128TH ST
Second Line	:	SUITE 530
City	:	KIRKLAND
State	:	WA
Zip	:	98034-7208
Country	:	US
Telephone Number	:	425-454-1111
Fax Number	:	425-454-7653

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	06/28/2012

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Directions to “ DR. PAUL H DREYFUSS MD” Practice Location

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