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NPI Code Detail

MEDICARE: JOHN R STREIDL MD

MEDICARE: JOHN R STREIDL 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
1207N00000XDermatology PhysicianMD00039710WA

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 : 1912931635
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN R STREIDL MD
Provider Business Mailing Address
First Line : PO BOX 5127
Second Line :
City : EVERETT
State : WA
Zip : 98206-5127
Country : US
Telephone Number : 206-860-5414
Fax Number : 206-720-8462
Provider Business Practice Location Address
First Line : 9709 3RD AVE NE
Second Line :
City : SEATTLE
State : WA
Zip : 98115-2062
Country : US
Telephone Number : 206-860-4748
Fax Number : 206-860-4756
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 09/04/2025

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