Individual
KEITH A MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 744-3462
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00017589
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972510014
—
WA
01
—
317076
WASHINGTON STATE LABOR AND INDUSTRIES
WA
Enumeration date
08/02/2006
Last updated
06/17/2021
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