Provider Demographics
NPI:1023184868
Name:WARNEKROS, WILLIAM BERG (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BERG
Last Name:WARNEKROS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 NE 45TH PL
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4028
Mailing Address - Country:US
Mailing Address - Phone:206-525-8869
Mailing Address - Fax:206-525-8870
Practice Address - Street 1:3216 NE 45TH PL
Practice Address - Street 2:SUITE 301
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4093
Practice Address - Country:US
Practice Address - Phone:206-525-8869
Practice Address - Fax:206-525-8870
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000296213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA17212OtherLABOR & INDUSTRY #
WA1726405Medicaid
WA17212OtherLABOR & INDUSTRY #
WA1726405Medicaid