Provider Demographics
NPI:1619666237
Name:NORTHWEST SURGICAL OF BELLEVUE
Entity type:Organization
Organization Name:NORTHWEST SURGICAL OF BELLEVUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:312-965-0963
Mailing Address - Street 1:10849 EMERALD CHASE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5881
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:636 120TH AVE NE STE A204
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3087
Practice Address - Country:US
Practice Address - Phone:425-307-3546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty