Provider Demographics
NPI:1083819866
Name:WEST SEATTLE FOOT & ANKLE CLINIC
Entity type:Organization
Organization Name:WEST SEATTLE FOOT & ANKLE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FERREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-937-4700
Mailing Address - Street 1:4520 42ND AVE SW
Mailing Address - Street 2:SUITE 34
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4240
Mailing Address - Country:US
Mailing Address - Phone:206-937-4700
Mailing Address - Fax:
Practice Address - Street 1:4520 42ND AVE SW
Practice Address - Street 2:SUITE 34
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4240
Practice Address - Country:US
Practice Address - Phone:206-937-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000396261QP1100X
WAPO00000739261QP1100X
WAPO00000236261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT83568Medicare UPIN
WAU95373Medicare UPIN
WAT91090Medicare UPIN