MEDICARE: KONSTANTIN KARMAZIN, M.D. PLLC

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	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1447959903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KONSTANTIN KARMAZIN, M.D. PLLC

Provider Business Mailing Address
First Line	:	6547 GREENWOOD AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-5223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6547 GREENWOOD AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-5223
Country	:	US
Telephone Number	:	206-801-0215
Fax Number	:	907-313-2122

Authorized Official
Title or Position	:	OWNER
Name	:	KONSTANTIN KARMAZIN
Credential	:	MD
Telephone Number	:	516-413-9024

Provider Enumeration Date	:	02/23/2023
Last Update Date	:	02/23/2023

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