Provider Demographics
NPI:1447442348
Name:TIMOTHY P. CAREY M.D. INC. P.S.
Entity type:Organization
Organization Name:TIMOTHY P. CAREY M.D. INC. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCULAR PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-522-2500
Mailing Address - Street 1:5116 25TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4121
Mailing Address - Country:US
Mailing Address - Phone:206-522-2500
Mailing Address - Fax:206-267-8307
Practice Address - Street 1:5116 25TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4121
Practice Address - Country:US
Practice Address - Phone:206-522-2500
Practice Address - Fax:206-267-8307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00024248261QA1903X, 261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE80288OtherUPIN
WA1078369Medicaid
WA1078369Medicaid