Provider Demographics
NPI:1679991087
Name:SEATTLE INFECTIOUS DISEASE CLINIC PLLC
Entity type:Organization
Organization Name:SEATTLE INFECTIOUS DISEASE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DINGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:206-329-0338
Mailing Address - Street 1:PO BOX 24303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0303
Mailing Address - Country:US
Mailing Address - Phone:203-329-0338
Mailing Address - Fax:
Practice Address - Street 1:1420A 25TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3016
Practice Address - Country:US
Practice Address - Phone:206-329-0338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty