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NPI Code Detail

MEDICARE: DR. BERHAN GHERMAY M.D.

MEDICARE: DR. BERHAN GHERMAY 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
1207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianMD065638LPA
2207P00000XEmergency Medicine PhysicianMD00042655WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1700085OTHERPAHIGHMARK BS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30459675000OTHERPAINDEPENDENCE BC

General Provider Information

NPI Number : 1508817222
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BERHAN GHERMAY M.D.
Provider Business Mailing Address
First Line : 1819 23RD AVE APT E305
Second Line :
City : SEATTLE
State : WA
Zip : 98122-2989
Country : US
Telephone Number : 206-973-0560
Fax Number :
Provider Business Practice Location Address
First Line : 1450 BATTERSBY AVE
Second Line :
City : ENUMCLAW
State : WA
Zip : 98022-3634
Country : US
Telephone Number : 360-825-2505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 10/06/2016

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