Provider Demographics
NPI:1952543217
Name:SEATTLE SPINE INSTITUTE PLLC
Entity Type:Organization
Organization Name:SEATTLE SPINE INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHWAEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-322-1765
Mailing Address - Street 1:550 16TH AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5699
Mailing Address - Country:US
Mailing Address - Phone:206-322-1765
Mailing Address - Fax:206-322-1785
Practice Address - Street 1:550 16TH AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5699
Practice Address - Country:US
Practice Address - Phone:206-322-1765
Practice Address - Fax:206-322-1785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00027530261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WABS0648076OtherDEA
WAG8877104Medicare PIN