Provider Demographics
NPI:1699798439
Name:MATE, TIM P (MD)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:P
Last Name:MATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1221 MADISON ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3588
Mailing Address - Country:US
Mailing Address - Phone:206-386-2198
Mailing Address - Fax:206-386-3888
Practice Address - Street 1:1221 MADISON ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3588
Practice Address - Country:US
Practice Address - Phone:206-386-2198
Practice Address - Fax:206-386-3888
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD000170492085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA920000433OtherRAIL ROAD MEDICARE
WA1018662Medicaid
WA000178903Medicare PIN
WAAB04884Medicare PIN
WA1018662Medicaid