Individual
DR. MARIEBETH BANGOY VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4915 25TH AVE NE, SUITE 300-W, SEATTLE, WA 98105-5667
(206) 525-7777
(206) 520-3288
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD2011-0765
NM
207Q00000X
Family Medicine Physician
Primary
MD60428752
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629212295
—
WA
Enumeration date
04/27/2009
Last updated
09/26/2014
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