Provider Demographics
NPI:1215981287
Name:EGGERS, JOHN R (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:EGGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 MADISON ST
Mailing Address - Street 2:STE 750
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3586
Mailing Address - Country:US
Mailing Address - Phone:206-386-2101
Mailing Address - Fax:206-215-4247
Practice Address - Street 1:1229 MADISON ST
Practice Address - Street 2:STE 750
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3586
Practice Address - Country:US
Practice Address - Phone:206-386-2101
Practice Address - Fax:206-215-4247
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00029948207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E24818Medicare UPIN
WA8856166Medicare ID - Type Unspecified