Active NPI
Ian Richard Sunderland, MD
- Surgery Physician
- Seattle, WA
National Provider Identifier
1376634816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ML20008408
- Practice address
- 1959 NE Pacific Street
C-212, Box 356340
Seattle, WA 98195-6340 - Phone
- (206) 543-0065
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ML20008408 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific Street
C-212, Box 356340
Seattle, WA 98195-6340
Mailing address
1959 NE Pacific Street
C-212, Box 356340
Seattle, WA 98195-6340
Phone (206) 543-0065
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ML20008408 | WA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376634816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC STREET",
"address_2": "C-212, BOX 356340",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981956340",
"telephone_number": "206-543-0065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC STREET",
"address_2": "C-212, BOX 356340",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981956340",
"telephone_number": "206-543-0065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDERLAND",
"first_name": "IAN",
"middle_name": "RICHARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "ML20008408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.