Individual
DR. MICHAEL RAY BAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.,
Contact information
Practice address
515 MINOR AVE STE 210, SEATTLE, WA 98104-2113
(206) 386-9500
(206) 386-9605
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OP60550961
WA
390200000X
Student in an Organized Health Care Education/Training Program
0116021855
VA
Other
Enumeration date
06/25/2009
Last updated
04/16/2021
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