Provider Demographics
NPI:1457363152
Name:DONALD J ROSS MD PS
Entity Type:Organization
Organization Name:DONALD J ROSS MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-522-8553
Mailing Address - Street 1:2271 NE 51ST STREET
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5713
Mailing Address - Country:US
Mailing Address - Phone:206-522-8553
Mailing Address - Fax:206-522-7815
Practice Address - Street 1:2271 NE 51ST STREET
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5713
Practice Address - Country:US
Practice Address - Phone:206-522-8553
Practice Address - Fax:206-522-7815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA025209MD000204842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA600584436000Medicare UPIN