Provider Demographics
NPI:1568791770
Name:JAMES P. GASPARICH, MD, PS
Entity Type:Organization
Organization Name:JAMES P. GASPARICH, MD, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:GASPARICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-292-6488
Mailing Address - Street 1:1221 MADISON ST
Mailing Address - Street 2:SUITE 1210
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3588
Mailing Address - Country:US
Mailing Address - Phone:206-292-6488
Mailing Address - Fax:206-838-5901
Practice Address - Street 1:1221 MADISON ST
Practice Address - Street 2:SUITE 1210
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3588
Practice Address - Country:US
Practice Address - Phone:206-292-6488
Practice Address - Fax:206-838-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019030208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB06837OtherMEDICARE
WAP00088402OtherMEDICARE RAILROAD
WAP00088402OtherMEDICARE RAILROAD