Provider Demographics
NPI:1336229319
Name:METZNER, IULIA IRINA
Entity Type:Individual
Prefix:
First Name:IULIA
Middle Name:IRINA
Last Name:METZNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:IRINA
Other - Last Name:METZNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HARBORVIEW MEDICAL CENTER
Practice Address - Street 2:325 9TH AVE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-731-3059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WATR00042856207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUWPCPR835Medicaid
WA0231562OtherL&I
310900OtherINTERNAL ID-MOTOR VEHICLE ID
WAUWPCPR835Medicaid
H97537Medicare UPIN