Basic Information
| Provider Information | |||||||||
| NPI: | 1215030853 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTY | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 BROADWAY | ||||||||
| Address2: | STE 707 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981224328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063866200 | ||||||||
| FaxNumber: | 2062549220 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 BROADWAY | ||||||||
| Address2: | STE 707 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981224328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063866200 | ||||||||
| FaxNumber: | 2062549220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD00019263 | WA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1010172 | 05 | WA | MEDICAID |