Provider Demographics
NPI:1437269974
Name:GILLESPIE, HAMILTON S (MD)
Entity Type:Individual
Prefix:
First Name:HAMILTON
Middle Name:S
Last Name:GILLESPIE
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 1:4011 TALBOT RD S STE 500
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5782
Mailing Address - Country:US
Mailing Address - Phone:425-690-3482
Mailing Address - Fax:425-690-9082
Practice Address - Street 1:4011 TALBOT RD S STE 500
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5782
Practice Address - Country:US
Practice Address - Phone:425-690-3482
Practice Address - Fax:425-690-9082
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00048050207RC0000X, 207RC0001X
ORMD178643207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500717739Medicaid
WA1010474Medicaid
8942028Medicare PIN