Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | MD60020198 | WA |
NPI | 1043337751 |
---|---|
Provider Name | Dr. Seth Hartung |
First Address | Everett, WA 98208-6647 |
Second Address | Everett, WA 98208-6647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 17/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001259300 | GROUP MEDICARE # (01) | WA |
MD60020198 | LICENSE (01) | WA |