Basic Information
Provider Information
NPI: 1518076280
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEILER
FirstName: DOUGLAS
MiddleName: PAUL
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1535
Address2:  
City: TACOMA
State: WA
PostalCode: 984011535
CountryCode: US
TelephoneNumber: 2537614200
FaxNumber: 2533833553
Practice Location
Address1: 1304 FAWCETT AVE
Address2: SUITE 100
City: TACOMA
State: WA
PostalCode: 984021911
CountryCode: US
TelephoneNumber: 2537614200
FaxNumber: 2533833553
Other Information
ProviderEnumerationDate: 08/29/2006
LastUpdateDate: 12/22/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XMD00045487WAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085N0700XMD00045487WAN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology

ID Information
IDTypeStateIssuerDescription
G887364001WAPTAN-UAOMOTHER
023644001WALABOR AND INDUSTRIES-UNION AVENUE OPEN MRIOTHER
023732001WALABOR AND INDUSTRIES-TRAOTHER
894759501WALABOR AND INDUSTRIES CRIME VICTIMS-TRAOTHER
894759401WALABOR AND INDUSTRIES CRIME VICTIMS-UNION AVENUE OPEN MRIOTHER


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