Provider Demographics
NPI:1457787533
Name:CENTRAL SEATTLE PANEL OF CONSULTANTS
Entity Type:Organization
Organization Name:CENTRAL SEATTLE PANEL OF CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SUVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-622-2305
Mailing Address - Street 1:411 12TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5523
Mailing Address - Country:US
Mailing Address - Phone:206-622-2305
Mailing Address - Fax:206-343-9364
Practice Address - Street 1:411 12TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5523
Practice Address - Country:US
Practice Address - Phone:206-622-2305
Practice Address - Fax:206-343-9364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA52670OtherWA L&I PROVIDER NUMBER