Individual
DR. ANDY ITSARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-3000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60585561
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013250786
—
WA
Enumeration date
04/01/2013
Last updated
09/06/2016
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