Prasit Phowthongkum, M.D.

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

ML60566212 Issued in WA

Practice address

Health Sciences BLDG K-253
University of Washington,Division of Medical Genetics
Seattle, WA 98195

Phone

(206) 616-4521

NPI assigned

Jul 6, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1235494105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 UNIVERSITY WAY NE",
            "address_2": "APT 519",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053537",
            "telephone_number": "267-210-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HEALTH SCIENCES BLDG K-253",
            "address_2": "UNIVERSITY OF WASHINGTON,DIVISION OF MEDICAL GENETICS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98195",
            "telephone_number": "206-616-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOWTHONGKUM",
        "first_name": "PRASIT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT201870",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "WA",
            "license": "ML60566212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Genetics (M.D.) Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Genetics (M.D.) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.