Provider Demographics
NPI:1922076520
Name:EL-GHAZZAWY, ADEL G (MD)
Entity Type:Individual
Prefix:
First Name:ADEL
Middle Name:G
Last Name:EL-GHAZZAWY
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 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:1231 116TH AVE NE
Practice Address - Street 2:SUITE 535
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3804
Practice Address - Country:US
Practice Address - Phone:425-688-1916
Practice Address - Fax:425-688-1901
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039270208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0146095OtherDEPT OF L&I
WA6942ELOtherREGENCE BLUE SHIELD
WA8274573Medicaid
WA0146095OtherDEPT OF L&I
WAG51109Medicare UPIN