Organization
PEDIATRIX MEDICAL GROUP OF WASHINGTON INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANETTE SANDERS (ASSISTANT SECRETARY)
(800) 243-3839
Entity
Organization
Contact information
Practice address
747 BROADWAY, SEATTLE, WA 98122-4379
(206) 386-6000
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(954) 384-0175
(954) 851-1948
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7083041
—
WA
05
—
7094139
—
WA
05
—
7097421
—
WA
05
—
7129364
—
WA
05
—
806317100
—
ID
05
—
MDG65WA
—
AK
05
—
MDG66WA
—
AK
05
—
MDG68WA
—
AK
05
—
MDG69WA
—
AK
Enumeration date
09/17/2006
Last updated
11/12/2024
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