Provider Demographics
NPI:1710056239
Name:OPSAHL, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:OPSAHL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12039 NE 128TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3030
Mailing Address - Country:US
Mailing Address - Phone:425-822-7662
Mailing Address - Fax:425-822-0172
Practice Address - Street 1:12039 NE 128TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3030
Practice Address - Country:US
Practice Address - Phone:425-822-7662
Practice Address - Fax:425-822-0172
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2012-10-24
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Provider Licenses
StateLicense IDTaxonomies
WAMD00043913207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F80339Medicare UPIN