Provider Demographics
NPI:1427161744
Name:CAPP, PHILIP KENNETH (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:KENNETH
Last Name:CAPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E JEFFERSON ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5698
Mailing Address - Country:US
Mailing Address - Phone:206-320-4888
Mailing Address - Fax:206-320-4203
Practice Address - Street 1:1600 E JEFFERSON ST
Practice Address - Street 2:SUITE 510
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5698
Practice Address - Country:US
Practice Address - Phone:206-320-4888
Practice Address - Fax:206-320-4203
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60035619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine