Provider Demographics
NPI:1023162831
Name:SEATTLE REPRODUCTIVE SURGERY CENTER
Entity type:Organization
Organization Name:SEATTLE REPRODUCTIVE SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:SOULES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-301-5000
Mailing Address - Street 1:1505 WESTLAKE AVE N
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3050
Mailing Address - Country:US
Mailing Address - Phone:206-301-5000
Mailing Address - Fax:
Practice Address - Street 1:1505 WESTLAKE AVE N
Practice Address - Street 2:SUITE 400
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-3050
Practice Address - Country:US
Practice Address - Phone:206-301-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical