Provider Demographics
NPI:1538138268
Name:PUTTLER, ERIC GEOFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:GEOFFREY
Last Name:PUTTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MADISON ST.
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:206-264-8689
Practice Address - Street 1:3801 5TH ST SE
Practice Address - Street 2:SUITE 110
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374
Practice Address - Country:US
Practice Address - Phone:253-845-9585
Practice Address - Fax:253-435-4785
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD27486207XX0801X
WAMD00046498207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8882275Medicare PIN