Provider Demographics
NPI:1306263322
Name:MORTON, TRENTON MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:TRENTON
Middle Name:MATTHEW
Last Name:MORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:17930 TALBOT RD S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6230
Mailing Address - Country:US
Mailing Address - Phone:425-228-3187
Mailing Address - Fax:425-228-7972
Practice Address - Street 1:17930 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6230
Practice Address - Country:US
Practice Address - Phone:425-228-3187
Practice Address - Fax:425-228-7972
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD606614862086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2036589Medicaid