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Individual

MATTHEW J MCCORMICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 OLIVE WAY MS/M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00034596
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0039587
LABOR AND INDUSTRIES
WA
01
2847MC
BLUE SHIELD NUMBER
WA
05
8252629
WA
01
US7916101
AETNA SPECIALIST PIN
WA
Enumeration date
10/04/2006
Last updated
04/07/2008
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