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NPI Code Detail

MEDICARE: ISAIAH SONG

MEDICARE: ISAIAH SONG
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
1213ES0103XFoot & Ankle Surgery PodiatristPO61292164WA

General Provider Information

NPI Number : 1700375953
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISAIAH SONG
Provider Business Mailing Address
First Line : 7600 EVERGREEN WAY
Second Line :
City : EVERETT
State : WA
Zip : 98203-6421
Country : US
Telephone Number : 206-860-5414
Fax Number :
Provider Business Practice Location Address
First Line : 1448 NW MARKET ST
Second Line :
City : SEATTLE
State : WA
Zip : 98107-3743
Country : US
Telephone Number : 206-782-7300
Fax Number : 206-414-7390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2018
Last Update Date : 05/26/2026

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