MEDICARE: DR. DOUGLAS S HALE DPM

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	213E00000X	Podiatrist	P427	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480012743	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790885358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS S HALE DPM

Provider Business Mailing Address
First Line	:	600 BROADWAY
Second Line	:	STE 220
City	:	SEATTLE
State	:	WA
Zip	:	98122-5395
Country	:	US
Telephone Number	:	206-344-3808
Fax Number	:	206-860-0907

Provider Business Practice Location Address
First Line	:	600 BROADWAY STE 220
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-5373
Country	:	US
Telephone Number	:	206-344-3808
Fax Number	:	206-860-0907

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

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	04/11/2012

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