Provider Demographics
NPI:1801850284
Name:WELCH, PHILIP D (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:D
Last Name:WELCH
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 1:801 BROADWAY
Mailing Address - Street 2:STE 628
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122
Mailing Address - Country:US
Mailing Address - Phone:206-622-1055
Mailing Address - Fax:206-215-6566
Practice Address - Street 1:801 BROADWAY
Practice Address - Street 2:STE 628
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122
Practice Address - Country:US
Practice Address - Phone:206-622-1055
Practice Address - Fax:206-215-6566
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018862207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAWE0424OtherREGENCE BS
WA1111368Medicaid
WAWE0424OtherREGENCE BS
A06750Medicare UPIN
WAGAB17164Medicare PIN