Provider Demographics
NPI:1457305401
Name:SCHWARTZ, SETH ROSLOW (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:ROSLOW
Last Name:SCHWARTZ
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 1:1100 9TH AVE
Mailing Address - Street 2:MS M4-PA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-583-6025
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5371207Y00000X
WAMD00047270207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD3585Medicaid
WA8480915Medicaid
WA3578SCOtherBLUE SHIELD #
WAP00393153OtherRAILROAD MC #
AKMD3107WMedicaid
8EA793Medicare ID - Type Unspecified
WA3578SCOtherBLUE SHIELD #
WA8864103Medicare PIN
WAIO9328Medicare UPIN
WA8897033Medicare PIN