Basic Information
Provider Information
NPI: 1225217011
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARSHALL
FirstName: SILAS
MiddleName: T.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 805 MADISON ST
Address2: SUITE 901
City: SEATTLE
State: WA
PostalCode: 981041172
CountryCode: US
TelephoneNumber: 2062648100
FaxNumber:  
Practice Location
Address1: 1231 116TH AVE NE
Address2: SUITE 750
City: BELLEVUE
State: WA
PostalCode: 980043804
CountryCode: US
TelephoneNumber: 4254553600
FaxNumber: 4254553920
Other Information
ProviderEnumerationDate: 10/29/2007
LastUpdateDate: 01/24/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XMD60386052WAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XX0801XMD60386052WAN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma

No ID Information.


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