Provider Demographics
NPI:1104077924
Name:ORTHOPEDICS INTERNATIONAL
Entity type:Organization
Organization Name:ORTHOPEDICS INTERNATIONAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:WHALEY
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:206-323-1900
Mailing Address - Street 1:1600 E JEFFERSON ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5698
Mailing Address - Country:US
Mailing Address - Phone:206-323-1900
Mailing Address - Fax:206-323-6868
Practice Address - Street 1:1601 116TH AVE NE
Practice Address - Street 2:SUITE 111
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3010
Practice Address - Country:US
Practice Address - Phone:206-323-1900
Practice Address - Fax:425-990-8311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG217111000Medicare Oscar/Certification