Basic Information
| Provider Information | |||||||||
| NPI: | 1710164918 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MINOR & JAMES MEDICAL PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 515 MINOR AVE | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981042120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063869500 | ||||||||
| FaxNumber: | 2065763802 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 MINOR AVE | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981042120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063869500 | ||||||||
| FaxNumber: | 2065763802 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2008 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | STEART | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2063869500 | ||||||||
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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 | 332B00000X | WA | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 5891740001 | 01 | WA | DME FH | OTHER | 78900 | 01 | WA | LABOR & INDUSTRY | OTHER | 7136872 | 01 | WA | MEDICAID / AUDIOLOGY | OTHER | CE1300 | 01 | PALMETTO / RR MEDICARE | OTHER | 0008864538 | 01 | MEDICARE / FHSC | OTHER | 9060666 | 01 | WA | MEDICAID / HEARING AIDS | OTHER | 7139439 | 01 | WA | MEDICAID / FHSC | OTHER | 1548250012 | 01 | NPI | OTHER | 7022544 | 05 | WA | MEDICAID | 7027352 | 01 | WA | MEDICAID / ASC ENDO UNIT | OTHER |