Individual
NICHOLAS J KASSEBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD60105936
WA
207LP3000X
Pediatric Anesthesiology Physician
MD60105936
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518160167
—
WA
Enumeration date
06/08/2007
Last updated
08/30/2018
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