Provider Demographics
NPI:1831262260
Name:HALL, STEVEN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39819 SE 60TH ST
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9152
Mailing Address - Country:US
Mailing Address - Phone:425-557-7706
Mailing Address - Fax:425-831-4612
Practice Address - Street 1:120 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3228
Practice Address - Country:US
Practice Address - Phone:425-557-7706
Practice Address - Fax:425-831-4612
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA250992083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAO6833Medicare UPIN