Provider Demographics
NPI:1922542323
Name:DAVID R DAWSON ORTHOPAEDIC SURGEON
Entity Type:Organization
Organization Name:DAVID R DAWSON ORTHOPAEDIC SURGEON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:TEIXEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-946-1800
Mailing Address - Street 1:720 S 320TH ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5254
Mailing Address - Country:US
Mailing Address - Phone:253-946-1800
Mailing Address - Fax:253-946-1805
Practice Address - Street 1:720 S 320TH ST
Practice Address - Street 2:SUITE G
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5254
Practice Address - Country:US
Practice Address - Phone:253-946-1800
Practice Address - Fax:253-946-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023760174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA07024Medicare UPIN