Basic Information
Provider Information
NPI: 1821051335
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEELEY
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1188 106TH AVE NE
Address2:  
City: BELLEVUE
State: WA
PostalCode: 980048614
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 515 MINOR AVE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981042120
CountryCode: US
TelephoneNumber: 4254552630
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT00003749WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home