Provider Demographics
NPI:1811041494
Name:FERNANDO VEGA MD
Entity Type:Organization
Organization Name:FERNANDO VEGA MD
Other - Org Name:SEATTLE HEALING ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:D
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-522-5646
Mailing Address - Street 1:6300 9TH AVE NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8515
Mailing Address - Country:US
Mailing Address - Phone:206-522-5646
Mailing Address - Fax:206-524-5054
Practice Address - Street 1:6300 9TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-8515
Practice Address - Country:US
Practice Address - Phone:206-522-5646
Practice Address - Fax:206-524-5054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty