Provider Demographics
NPI:1023357845
Name:GEORGE, SAMUEL EVERETT (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:EVERETT
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-474-2001
Mailing Address - Fax:206-764-8005
Practice Address - Street 1:19005 SE 34TH ST BLDG 3
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683
Practice Address - Country:US
Practice Address - Phone:360-726-6720
Practice Address - Fax:360-726-6729
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2018-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA60289820207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX38944Medicare UPIN