Provider Demographics
NPI:1770575078
Name:HESS, JOHN RIDER (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RIDER
Last Name:HESS
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 50095, SEATTLE, WA 98145
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-543-6420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00015060207ZP0105X, 207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA207ZB0001XOtherPATHOLOGY - BLOOD BANKING & TRANSFUSION MEDICINE WA MD00015060
WA1770575078Medicaid
WA207ZP0105XOtherPATHOLOGY - CLINICAL PATHOLOGY/LABORATORY MEDICINE WA MD00015060
WA8914481Medicare PIN
WA1770575078Medicaid
MDD395Medicare PIN
MD970400100Medicaid