Basic Information
| Provider Information | |||||||||
| NPI: | 1689656597 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CURTIS | ||||||||
| FirstName: | MILTON | ||||||||
| MiddleName: | LEO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 34036 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981241036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258993292 | ||||||||
| FaxNumber: | 4258993269 | ||||||||
| Practice Location | |||||||||
| Address1: | 18208 66TH AVE NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | KENMORE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980287949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254856561 | ||||||||
| FaxNumber: | 4254884939 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2005 | ||||||||
| LastUpdateDate: | 02/16/2011 | ||||||||
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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 | 207Q00000X | MD00018582 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 134910 | 01 | WA | LABOR & INDUSTRIES | OTHER | CU8175 | 01 | WA | BLUE SHIELD | OTHER | 080149067 | 01 | WA | MEDICARE RAILROAD | OTHER | 1920008 | 05 | WA | MEDICAID |