Provider Demographics
NPI:1467873885
Name:NATALIA DVORAK, MD, PLLC
Entity Type:Organization
Organization Name:NATALIA DVORAK, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DVORAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-454-0345
Mailing Address - Street 1:1600 116TH AVE NE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3014
Mailing Address - Country:US
Mailing Address - Phone:425-454-0345
Mailing Address - Fax:425-455-4451
Practice Address - Street 1:1600 116TH AVE NE
Practice Address - Street 2:SUITE 104
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3014
Practice Address - Country:US
Practice Address - Phone:425-454-0345
Practice Address - Fax:425-455-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60269809207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty