Individual
LYLE S SORENSEN
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 9TH AVE, MS:M4-PA, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00029594
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039594
LABOR AND INDUSTRIES #
WA
05
—
8148686
—
WA
05
—
MD9594
—
AK
01
—
SO5081
BLUE SHIELD #
WA
01
—
US0862500
AETNA SPECIALIST PIN
WA
Enumeration date
10/11/2006
Last updated
06/17/2008
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