Provider Demographics
NPI:1144300542
Name:SETO, SAMUEL K (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:K
Last Name:SETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:21911 76TH AVE W
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7903
Mailing Address - Country:US
Mailing Address - Phone:425-774-7723
Mailing Address - Fax:425-778-2788
Practice Address - Street 1:21911 76TH AVE W
Practice Address - Street 2:SUITE 101
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7903
Practice Address - Country:US
Practice Address - Phone:425-774-7723
Practice Address - Fax:425-778-2788
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2023-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00032689207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA019394001OtherDMERC PROVIDER NUMBER
WA101465OtherL&I PROVIDER NUMBER
WA1094564Medicaid
WASE5264OtherREGENCE PROVIDER NUMBER
WA1094564Medicaid
WAG11943Medicare UPIN