Provider Demographics
NPI:1164460515
Name:ORTHOPEDICS INTERNATIONAL LTD. PS
Entity type:Organization
Organization Name:ORTHOPEDICS INTERNATIONAL LTD. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:N
Authorized Official - Last Name:WEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-323-1900
Mailing Address - Street 1:901 BOREN AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3534
Mailing Address - Country:US
Mailing Address - Phone:206-323-1900
Mailing Address - Fax:206-323-6868
Practice Address - Street 1:901 BOREN AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3534
Practice Address - Country:US
Practice Address - Phone:206-323-1900
Practice Address - Fax:206-323-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6404380001Medicare NSC
WAG217111000Medicare PIN
G217111000Medicare UPIN