Provider Demographics
NPI:1437114576
Name:ABRAMOWITZ, KELVYN (MD)
Entity Type:Individual
Prefix:DR
First Name:KELVYN
Middle Name:
Last Name:ABRAMOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58009
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-1009
Mailing Address - Country:US
Mailing Address - Phone:425-235-4181
Mailing Address - Fax:425-277-3785
Practice Address - Street 1:5300 TALLMAN AVE NW
Practice Address - Street 2:OR SWEDISH MEDICAL CENTER BALLARD
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3932
Practice Address - Country:US
Practice Address - Phone:206-781-6369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025248207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1052414Medicaid
WA09334OtherL AND I
69236639OtherUBI
WA1052414Medicaid