Provider Demographics
NPI:1710163639
Name:DR GRABOWSKI PC
Entity Type:Organization
Organization Name:DR GRABOWSKI PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:EMELIA
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-389-0079
Mailing Address - Street 1:1101 MADISON ST
Mailing Address - Street 2:SUITE 1120
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1306
Mailing Address - Country:US
Mailing Address - Phone:206-447-0302
Mailing Address - Fax:206-682-5951
Practice Address - Street 1:1101 MADISON ST
Practice Address - Street 2:SUITE 1120
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1306
Practice Address - Country:US
Practice Address - Phone:206-447-0302
Practice Address - Fax:206-682-5951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000825213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA756480615OtherRAILDROAD MEDICARE
WA0227706OtherL&I INSURANCE
WA739736Medicaid
WA6023190001Medicare NSC
WA8868757Medicare PIN