Provider Demographics
NPI:1356575849
Name:ANESTHESIA AND PAIN SERVICE
Entity type:Organization
Organization Name:ANESTHESIA AND PAIN SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRAUTMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:206-930-7466
Mailing Address - Street 1:17717 17TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3311
Mailing Address - Country:US
Mailing Address - Phone:206-930-7466
Mailing Address - Fax:
Practice Address - Street 1:10330 MERIDIAN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9451
Practice Address - Country:US
Practice Address - Phone:206-368-6640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033661261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center