Basic Information
| Provider Information | |||||||||
| NPI: | 1801966288 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEPHEN MARKOWITZ | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 84554 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981245854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253533788 | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 TERRY AVE | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981044230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063821021 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 01/30/2013 | ||||||||
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| AuthorizedOfficialLastName: | MARKOWITZ | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4253533788 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 7056773 | 05 | WA | MEDICAID | 0037961 | 01 | WA | L & I | OTHER |