Provider Demographics
NPI:1417915745
Name:COWEN, SHELDON JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:JAY
Last Name:COWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:515 MINOR AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2120
Mailing Address - Country:US
Mailing Address - Phone:206-624-5288
Mailing Address - Fax:206-628-4321
Practice Address - Street 1:515 MINOR AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2120
Practice Address - Country:US
Practice Address - Phone:206-624-5288
Practice Address - Fax:206-628-4321
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00025992207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1100478Medicaid
WA911706205OtherTAX ID
WA1100478Medicaid
WAB63866Medicare UPIN