Provider Demographics
NPI:1831146422
Name:MATRIX ANESTHESIA, PS
Entity Type:Organization
Organization Name:MATRIX ANESTHESIA, PS
Other - Org Name:OVERLAKE ANESTHESIOLOGISTS, PS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:STRIGENZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-451-4141
Mailing Address - Street 1:PO BOX 24503
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0503
Mailing Address - Country:US
Mailing Address - Phone:425-451-4141
Mailing Address - Fax:425-451-4144
Practice Address - Street 1:1035 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4604
Practice Address - Country:US
Practice Address - Phone:425-451-4141
Practice Address - Fax:425-451-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600257248207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7822000Medicaid
WAG000155300Medicare PIN