Provider Demographics
NPI:1851455893
Name:RITTENBERG, STEVEN W (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:RITTENBERG
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:PO BOX 34472
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1472
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:12917 SE 38TH ST
Practice Address - Street 2:STE 100
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1349
Practice Address - Country:US
Practice Address - Phone:425-641-4000
Practice Address - Fax:206-320-5840
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033053207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8188823Medicaid
8856621Medicare ID - Type Unspecified
G26737Medicare UPIN