MEDICARE: OBSTETRIX MEDICAL GROUP OF WASHINGTON INC PS

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician
2	207V00000X	Obstetrics & Gynecology Physician
3	2080N0001X	Neonatal-Perinatal Medicine Physician
4	2085U0001X	Diagnostic Ultrasound Physician
5	363LF0000X	Family Nurse Practitioner
6	363LW0102X	Women's Health Nurse Practitioner
7	207VM0101X	Maternal & Fetal Medicine Physician

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

NPI Number	:	1861599573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OBSTETRIX MEDICAL GROUP OF WASHINGTON INC PS

Provider Business Mailing Address
First Line	:	1301 CONCORD TER
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2843
Country	:	US
Telephone Number	:	954-384-0175
Fax Number	:	954-851-1948

Provider Business Practice Location Address
First Line	:	1229 MADISON ST STE 750
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-3540
Country	:	US
Telephone Number	:	206-386-2101
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	NANETTE SANDERS
Credential	:
Telephone Number	:	800-243-3839

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	10/23/2024

1229 MADISON ST
SEATTLE, WA
98104-3540

Practice Phone: 206-386-2101
Practice Fax: 206-386-2555