Provider Demographics
NPI:1932209947
Name:EICHNER, MANFRED HARRO (MD)
Entity Type:Individual
Prefix:MR
First Name:MANFRED
Middle Name:HARRO
Last Name:EICHNER
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 1:12911 120TH AVENUE NE
Mailing Address - Street 2:SUITE F180
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-821-3000
Mailing Address - Fax:425-823-6755
Practice Address - Street 1:12911 120TH AVENUE NE
Practice Address - Street 2:SUITE F180
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-821-3000
Practice Address - Fax:425-823-6755
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020653208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA627OtherL & I
WA1016625OtherDSHS
WA1016625OtherDSHS