Provider Demographics
NPI:1336118744
Name:KRENGEL, WALTER F III (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:F
Last Name:KRENGEL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:PO BOX 5371 M/S OA.9.120
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-5678
Mailing Address - Fax:206-987-3852
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:M/S OA.9.120
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-5678
Practice Address - Fax:206-987-3852
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00024404207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB16962Medicare ID - Type Unspecified
WAE72730Medicare UPIN