Individual
PAUL L SICURO
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 MSC M4-PA, SEATTLE, WA 98101-1873
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00028778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039587
LABOR & INDUSTRY
WA
01
—
300085697
RAILROAD MEDICARE
—
01
—
806245800
IDAHO MEDICAID
WA
05
—
8156846
—
WA
01
—
8893441
MEDICARE PTAN
WA
01
—
8894522
MEDICARE WINSLOW PTAN
WA
01
—
MD8779
ALASKA MEDICAID
WA
01
—
SI3333
BLUE SHIELD
WA
01
—
US0864876
AETNA/USHC SPECIALIST
WA
Enumeration date
08/20/2006
Last updated
10/19/2010
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