Provider Demographics
NPI:1841392842
Name:KIRTLAND, STEVEN H (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:H
Last Name:KIRTLAND
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 1:1100 9TH AVE
Mailing Address - Street 2:MS:M4-PFS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025610207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
290012368OtherRAILROAD MEDICARE
WA003788000OtherIDAHO MEDICAID
WA8118192Medicaid
WAMD5610OtherALASKA MEDICAID
WAUS0899973OtherAETNA/USHC SPECIALIST
WA0039574OtherLABOR & INDUSTRY
WAUS0818962OtherAETNA/USHC PCP
WAKI2321OtherBLUE SHIELD
WA8118192Medicaid
WA8809219Medicare PIN
WAMD5610OtherALASKA MEDICAID
WAUS0899973OtherAETNA/USHC SPECIALIST