Provider Demographics
NPI:1033190889
Name:SEATTLE HAND SURGERY GROUP PC
Entity Type:Organization
Organization Name:SEATTLE HAND SURGERY GROUP PC
Other - Org Name:SEATTLE HAND REHABILITATION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:206-292-6252
Mailing Address - Street 1:600 BROADWAY
Mailing Address - Street 2:SUITE 440
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122
Mailing Address - Country:US
Mailing Address - Phone:206-292-6252
Mailing Address - Fax:206-292-7893
Practice Address - Street 1:600 BROADWAY
Practice Address - Street 2:SUITE 440
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122
Practice Address - Country:US
Practice Address - Phone:206-292-6252
Practice Address - Fax:206-292-7893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7064116Medicaid