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Individual

MICHAEL JOSEPH LONGO

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
207RC0000X
Cardiovascular Disease Physician
Primary
MD00037280
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060057141
RAILROAD MEDICARE
WA
01
1508838467
MONTANA MEDICAID
WA
05
8243628
WA
01
L05190
INDIVIDUAL BLUE SHIELD
WA
01
MD6212
ALASKA MEDICAID
WA
Enumeration date
02/06/2006
Last updated
08/31/2011
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