Provider Demographics
NPI:1154351807
Name:ADVANCED BREAST TECHONOLOGY
Entity type:Organization
Organization Name:ADVANCED BREAST TECHONOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:R
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-292-7440
Mailing Address - Street 1:405 BLACK HILLS LN SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8661
Mailing Address - Country:US
Mailing Address - Phone:360-292-7440
Mailing Address - Fax:360-292-7444
Practice Address - Street 1:3920 CAPITOL MALL DR SW
Practice Address - Street 2:#100
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8700
Practice Address - Country:US
Practice Address - Phone:360-292-7440
Practice Address - Fax:360-292-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA708511Medicaid
WA708511Medicaid