PACIFIC HEAD & NECK SURGERY, PLLC (NPI# 1366610529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366610529 |
| Entity Type | Organization |
| Organization Name | PACIFIC HEAD & NECK SURGERY, PLLC |
| Practice Address |
600 Broadway Suite 260 Seattle WA 98122-5395 |
| Practice Telephone | 2064672747 |
| Practice Fax Number | 2064671591 |
| Mailing Telephone | 2064672747 |
| Mailing Fax Number | 2064671591 |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-11 |
| Authorized Official Name | STEPHEN KENT CLARK (PHYSICIAN/ LLC MEMBER) |
| Authorized Official Telephone | 2064672747 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | MD00014942 | WA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PACIFIC HEAD & NECK SURGERY, PLLC | 1221 Second Ave # 500, Seattle, WA 98101-2925 |
| Street Address |
600 BROADWAY SUITE 260 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98122-5395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871574624 | John A Miyano | Orthopaedic Surgery | 600 Broadway, Suite 440, Seattle, WA 98122 | 2005-11-09 |
| 1912546011 | Carina Renee Ziegler | Counselor | 600 Broadway, Seattle, WA 98122-5229 | 2020-01-06 |
| 1477194520 | Michael Gonzalez | Counselor | 600 Broadway, Seattle, WA 98122-5229 | 2019-09-30 |
| 1356999213 | Jennifer Mira Alsdorf | Counselor | 600 Broadway, Seattle, WA 98122-5229 | 2019-09-03 |
| 1780231316 | Allyson Bortoletto | Student in an Organized Health Care Education/Training Program | 600 Broadway, Seattle, WA 98122-5229 | 2019-08-19 |
| 1295202547 | Frauke Dorothea John | Student in an Organized Health Care Education/Training Program | 600 Broadway, Suite 170, Seattle, WA 98122 | 2018-10-25 |
| 1457863532 | Rebecca Locker Bean | Social Worker | 600 Broadway, Seattle, WA 98122-5229 | 2017-10-30 |
| 1235658527 | Jens Cinquemani | Social Worker | 600 Broadway, Seattle, WA 98122-5229 | 2017-09-18 |
| 1053830349 | Keylee Bernardita Fernandez | Student in an Organized Health Care Education/Training Program | 600 Broadway, Seattle, WA 98122-5229 | 2017-09-18 |
| 1225557515 | Maria Mohamed Abdullahi | Student in an Organized Health Care Education/Training Program | 600 Broadway, Seattle, WA 98122-5229 | 2017-09-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938506 | Quality Counseling and Consultation Service LLC | Counselor | 1525 Harvard Ave #509, Seattle, WA 98122 | 2020-07-01 |
| 1912535626 | Cesar Andrade | Student in an Organized Health Care Education/Training Program | 550 16th Avenue #400, Seattle, WA 98122 | 2020-03-29 |
| 1366089666 | Peter Nguyen | Pharmacy Technician | 914 East Jefferson Street, Campion Hall, Seattle, WA 98122 | 2019-12-05 |
| 1356903140 | Jason Dandino | Specialist/Technologist | 550 14th Avenue, Seattle, WA 98122 | 2019-07-02 |
| 1962066415 | Seattle Colleges | Local Education Agency (LEA) | Mainstay At Seattle Central College, 1701 Broadway Ms Be3210, Seattle, WA 98122 | 2019-04-30 |
| 1538621412 | Mitchell R Ornelas | Student in an Organized Health Care Education/Training Program | Swedish Family Medicine Residency Cherry Hill; 550 16th, Avenue #400, Seattle, WA 98122 | 2019-04-01 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1639646821 | Maritza E Cajiao | Doula | 747 Broadway, Seattle, Seattle, WA 98122 | 2018-10-25 |
| 1336616762 | Suzanna M Lovin | Social Worker | 401 Broadway, 1st Floor, Seattle, WA 98122 | 2018-10-24 |
| 1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
| Find all providers in zip 98122 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689007320 | Aria Jafari | Otolaryngology | 1959 Ne Pacific St # 356515, Seattle, WA 98195-3729 | 2013-08-16 |
| 1457628497 | Robin Lee Downey | Otolaryngology | 4020 Aurora Ave N Apt 410, Seattle, WA 98103-7882 | 2011-11-18 |
| 1043453533 | Sapna Ashok Patel | Otolaryngology | 600 Broadway Ste 280, Seattle, WA 98122-5371 | 2009-04-13 |
| 1588858534 | Deborah Susan Alt | Otolaryngology | 3451 22nd Ave W, Unit B, Seattle, WA 98199-2308 | 2007-09-04 |
| 1366590820 | Nilesh S. Shah | Otolaryngology | 1536 N 115th St Ste 340, Seattle, WA 98133-8412 | 2007-01-08 |
| 1376626796 | Agnes Kau Wah Yue | Otolaryngology | 1801 Nw Market Street, Suite 410, Seattle, WA 98107-3909 | 2006-10-21 |
| 1487757332 | Marc Dante Coltrera | Otolaryngology | Dept. Oto-hns, University of Washington, 1959 Ne Pacific, Seattle, WA 98195 | 2006-09-06 |
| 1609834258 | Constantine W Palaskas | Otolaryngology | 1221 Madison St Ste 1410, Seattle, WA 98104-3555 | 2006-05-03 |
| 1326005968 | Jonathan Chinn | Otolaryngology | 1551 Nw 54th, Ste 101, Seattle, WA 98107 | 2006-04-27 |
| 1518943646 | Joseph Christopher Sniezek | Otolaryngology | 1221 Madison St, Suite 1523, Seattle, WA 98104-3588 | 2005-12-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.