Provider Demographics
NPI:1730404286
Name:ALTON, TIMOTHY BRUCE (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:BRUCE
Last Name:ALTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MADISON ST STE 901
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:4011 TALBOT RD S STE 300
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5791
Practice Address - Country:US
Practice Address - Phone:425-656-5060
Practice Address - Fax:425-656-5047
Is Sole Proprietor?:No
Enumeration Date:2010-03-27
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60476247207XX0801X, 207X00000X
MN61416207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA363539OtherWA STATE LABOR & INDUSTRIES
8940710Medicare PIN
WA363539OtherWA STATE LABOR & INDUSTRIES