Provider Demographics
NPI:1487041406
Name:ABAD-SANTOS, MATTHEW
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:ABAD-SANTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST BOX 357115
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:206-314-2889
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC STREET
Practice Address - Street 2:DEPARTMENT OF INTERVENTIONAL RADIOLOGY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0470
Practice Address - Country:US
Practice Address - Phone:206-314-2889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA610484272085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology