Basic Information
| Provider Information | |||||||||
| NPI: | 1871000257 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'REILLY | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | KEVIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1959 NE PACIFIC STREET BOX 357115 | ||||||||
| Address2: | UNIVERSITY OF WASHINGTON DEPT OF RADIOLOGY | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065985130 | ||||||||
| FaxNumber: | 2065988475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1959 NE PACIFIC STREET | ||||||||
| Address2: | UNIVERSITY OF WASHINGTON DEPT OF RADIOLOGY | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065985130 | ||||||||
| FaxNumber: | 2065988475 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2018 | ||||||||
| LastUpdateDate: | 01/07/2018 | ||||||||
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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 | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.