Provider Demographics
NPI:1215466347
Name:WEBB, SETH (DNP PNP)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:
Last Name:WEBB
Suffix:
Gender:M
Credentials:DNP PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 12TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5175
Mailing Address - Country:US
Mailing Address - Phone:360-413-8470
Mailing Address - Fax:
Practice Address - Street 1:3434 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5175
Practice Address - Country:US
Practice Address - Phone:360-413-8470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-80169-112208000000X
WAAP61400664208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA390200000XMedicaid