Basic Information
| Provider Information | |||||||||
| NPI: | 1982715223 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORLIN | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | LEONARD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 LIND AVE SW STE 100 | ||||||||
| Address2: | |||||||||
| City: | RENTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980574970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252283440 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1019 112TH ST SW | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982044875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255516200 | ||||||||
| FaxNumber: | 4255516017 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 207R00000X | MD00045750 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | MD00045750 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 1037304 | 05 | WA | MEDICAID |