MEDICARE: DAVID ROBERT HAYNOR 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	2085R0202X	Diagnostic Radiology Physician	MD00018667	WA

General Provider Information

NPI Number	:	1700981420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ROBERT HAYNOR MD

Provider Business Mailing Address
First Line	:	1959 NE PACIFIC ST
Second Line	:	UNIV WASHINGTON BOX 3577115
City	:	SEATTLE
State	:	WA
Zip	:	98195-7115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST
Second Line	:	UNIV WASHINGTON BOX 3577115
City	:	SEATTLE
State	:	WA
Zip	:	98195-7115
Country	:	US
Telephone Number	:	206-543-3320
Fax Number	:

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/08/2007

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