Provider Demographics
NPI:1558417964
Name:ORTHOPEDICS INTERNATIONAL LTD PS
Entity Type:Organization
Organization Name:ORTHOPEDICS INTERNATIONAL LTD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:N
Authorized Official - Last Name:WEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-329-0585
Mailing Address - Street 1:901 BOREN AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3534
Mailing Address - Country:US
Mailing Address - Phone:206-329-0585
Mailing Address - Fax:206-324-6925
Practice Address - Street 1:600 BROADWAY
Practice Address - Street 2:SUITE 460
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5312
Practice Address - Country:US
Practice Address - Phone:206-329-0585
Practice Address - Fax:206-324-6925
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPEDICS INTERNATIONAL LTD P.S.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-26
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00095501Medicare PIN
WAGAB21763Medicare PIN