Basic Information
| Provider Information | |||||||||
| NPI: | 1629002597 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEAHURST PEDIATRICS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 34935 | ||||||||
| Address2: | DEPT # 61 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981241935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064394888 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16233 SYLVESTER RD SW | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062427822 | ||||||||
| FaxNumber: | 2062442133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 10/18/2012 | ||||||||
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| AuthorizedOfficialLastName: | RABINOWITZ | ||||||||
| AuthorizedOfficialFirstName: | DESMOND | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2062427822 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD00019385 | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.