Provider Demographics
NPI:1558349076
Name:WALTMAN, DENNIS D (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:D
Last Name:WALTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 MADISON ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1306
Mailing Address - Country:US
Mailing Address - Phone:206-215-2004
Mailing Address - Fax:206-215-2055
Practice Address - Street 1:11919 NE 128TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7204
Practice Address - Country:US
Practice Address - Phone:425-821-6655
Practice Address - Fax:425-821-8836
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2008-08-21
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Provider Licenses
StateLicense IDTaxonomies
WAMD00015138207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8178832Medicaid
WA0103456OtherLABOR & INDUSTRIES
W182OtherREGENCE HEALTHCARE
180031665OtherRAILROAD MEDICARE
180031665OtherRAILROAD MEDICARE
WA8872933Medicare PIN