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Organization

CARRIE J. BAGATELL, M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARRIE J BAGATELL MD (OWNER)
(206) 242-7900
Entity
Organization

Contact information

Practice address
16259 SYLVESTER RD SW, SUITE 504, BURIEN, WA 98166-3049
(206) 242-7900
Mailing address
16259 SYLVESTER RD SW, SUITE 504, BURIEN, WA 98166-3049
(206) 592-5000
(206) 824-9510

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110214053
RR MEDICARE
WA
05
1112044
WA
Enumeration date
07/23/2006
Last updated
05/12/2014
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