Provider Demographics
NPI:1841379369
Name:SEATTLE EAR NOSE THROAT TR
Entity Type:Organization
Organization Name:SEATTLE EAR NOSE THROAT TR
Other - Org Name:SEATTLE EAR, NOSE THROAT TR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-389-7100
Mailing Address - Street 1:PO BOX 3129
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98046-3129
Mailing Address - Country:US
Mailing Address - Phone:425-712-3417
Mailing Address - Fax:425-712-3710
Practice Address - Street 1:10330 MERIDIAN AVE N
Practice Address - Street 2:SUITE 190
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9451
Practice Address - Country:US
Practice Address - Phone:206-389-7100
Practice Address - Fax:206-389-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045832207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00377059OtherRAILROAD MEDICARE
WAG8863249Medicare PIN