Provider Demographics
NPI:1700836947
Name:STEIN, MATTHEW ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ALEXANDER
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:19020 33RD AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM-74712085R0202X
WAMD000362582085R0202X
UT264848-12052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000010153994OtherREGENCE BLUE SHIELD
WA0392619OtherLNI-EVERGREEN RADIA
WA0392328OtherLNI-RADIA KING COUNTY
WA0392326OtherLNI-RADIA REST OF WA
WA1016819Medicaid
WA0392330OtherLNI-SWEDISH RADIA EDMONDS
WA8225690Medicaid
WAB5445OtherBLUE CROSS OF IDAHO