Provider Demographics
NPI:1700855491
Name:HAPUTA, ANDREW J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:HAPUTA
Suffix:
Gender:M
Credentials:MD
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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:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:206-264-8689
Practice Address - Street 1:16122 8TH AVE SW
Practice Address - Street 2:SUITE D-1
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2967
Practice Address - Country:US
Practice Address - Phone:206-244-1680
Practice Address - Fax:206-243-8845
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2011-10-11
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Provider Licenses
StateLicense IDTaxonomies
WAMD0044349208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8854760Medicare ID - Type Unspecified
WAI35890Medicare UPIN