Provider Demographics
NPI:1891804977
Name:MITCHELL, FRANK KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:KENNETH
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4915 25TH AVE NE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5667
Mailing Address - Country:US
Mailing Address - Phone:206-524-4737
Mailing Address - Fax:206-522-5236
Practice Address - Street 1:4915 25TH AVE NE
Practice Address - Street 2:SUITE 301
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5667
Practice Address - Country:US
Practice Address - Phone:206-524-4737
Practice Address - Fax:206-522-5236
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00013240207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1236306Medicaid
WA000156301Medicare ID - Type Unspecified
WA1236306Medicaid