Provider Demographics
NPI:1487688065
Name:CONTI, NEAL R (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:R
Last Name:CONTI
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 OLIVE WAY MSC M4-PA
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1873
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
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:2006-07-10
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000379322085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0039587OtherLABOR & INDUSTRY
P00097938OtherRAILROAD MEDICARE
WA1487688065OtherMONTANA DSHS
WA8254443Medicaid
WAMD4357WOtherALASKA MEDICAID
WA6243COOtherBLUE SHIELD
WAUS5242569OtherAETNA/USHC SPECIALIST
WAAB38957Medicare PIN
H15028Medicare UPIN
WA0039587OtherLABOR & INDUSTRY
WA6243COOtherBLUE SHIELD