Provider Demographics
NPI:1043337751
Name:HARTUNG, SETH
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:
Last Name:HARTUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12728 19TH AVE SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6647
Mailing Address - Country:US
Mailing Address - Phone:425-252-1116
Mailing Address - Fax:425-252-1118
Practice Address - Street 1:12728 19TH AVE SE
Practice Address - Street 2:SUITE 200
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6647
Practice Address - Country:US
Practice Address - Phone:425-252-1116
Practice Address - Fax:425-252-1118
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60020198207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD60020198OtherLICENSE
WA0001259300OtherGROUP MEDICARE #