Individual
DR. PETER R MANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1231 116TH AVE NE, SUITE 750, BELLEVUE, WA 98004-3804
(425) 455-3600
(425) 455-3920
Mailing address
805 MADISON ST., SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
(206) 264-8689
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00023819
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0182419
L & I
WA
01
—
G8861216
MEDICARE POSM
WA
01
—
G8899975
MEDICARE EMRI
WA
01
—
P00284046
MEDICARE RR KING CO.
WA
Enumeration date
03/16/2006
Last updated
05/15/2012
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