Provider Demographics
NPI:1770678385
Name:VATH, RAYMOND EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:EUGENE
Last Name:VATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 MADISON ST.,
Mailing Address - Street 2:SUITE 1210
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-386-3103
Mailing Address - Fax:206-386-3123
Practice Address - Street 1:1229 MADISON ST.,
Practice Address - Street 2:SUITE 1210
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-386-3103
Practice Address - Fax:206-386-3123
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000096702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry