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NPI Code Detail

MEDICARE: HEAD & NECK SURGERY ASSOCIATES

MEDICARE: HEAD & NECK SURGERY ASSOCIATES
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
1174400000XSpecialistMDWA

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 : 1558420091
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEAD & NECK SURGERY ASSOCIATES
Provider Business Mailing Address
First Line : 1221 MADISON ST,
Second Line : SUITE#1523
City : SEATTLE
State : WA
Zip : 98104
Country : US
Telephone Number : 206-292-6464
Fax Number : 206-292-3498
Provider Business Practice Location Address
First Line : 1221 MADISON ST,
Second Line : SUITE#1523
City : SEATTLE
State : WA
Zip : 98104
Country : US
Telephone Number : 206-292-6464
Fax Number : 206-292-3498
Authorized Official
Title or Position : PRESIDENT
Name : DR. DAVID W MOORE
Credential : MD
Telephone Number : 206-292-6464
Provider Enumeration Date : 12/08/2006
Last Update Date : 08/22/2020

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Directions to “HEAD & NECK SURGERY ASSOCIATES ” Practice Location

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