Provider Demographics
NPI:1316020159
Name:FUTRAN, NEAL DAVID (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:DAVID
Last Name:FUTRAN
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC STREET
Mailing Address - Street 2:BOX 356515
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6515
Mailing Address - Country:US
Mailing Address - Phone:206-543-5230
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 356515
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6515
Practice Address - Country:US
Practice Address - Phone:206-598-3510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAME33244207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1316020159Medicaid
WA000121129Medicare PIN
WA1316020159Medicaid