Provider Demographics
NPI:1649279894
Name:CADERA, WERNER (MD)
Entity type:Individual
Prefix:DR
First Name:WERNER
Middle Name:
Last Name:CADERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6989
Mailing Address - Street 2:MAIL STOP 18913
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97228-6989
Mailing Address - Country:US
Mailing Address - Phone:206-858-7000
Mailing Address - Fax:206-858-7050
Practice Address - Street 1:10330 MERIDIAN AVE N
Practice Address - Street 2:SUITE 370
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9451
Practice Address - Country:US
Practice Address - Phone:206-528-6000
Practice Address - Fax:206-528-0014
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029760207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA116076OtherL & I
WA8140980Medicaid
WA000170106Medicare ID - Type UnspecifiedSEATTLE CLINIC
WAAB08899Medicare ID - Type UnspecifiedSEQUIM CLINIC
WA8140980Medicaid