Basic Information
| Provider Information | |||||||||
| NPI: | 1558417964 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORTHOPEDICS INTERNATIONAL LTD PS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 BOREN AVE | ||||||||
| Address2: | SUITE 800 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981043534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063290585 | ||||||||
| FaxNumber: | 2063246925 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 BROADWAY | ||||||||
| Address2: | SUITE 460 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981225312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063290585 | ||||||||
| FaxNumber: | 2063246925 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 11/09/2010 | ||||||||
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| AuthorizedOfficialLastName: | WEN | ||||||||
| AuthorizedOfficialFirstName: | MARCO | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2063290585 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ORTHOPEDICS INTERNATIONAL LTD P.S. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.