Provider Demographics
NPI:1487768875
Name:WESTCOTT, ROGER J (M D)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:J
Last Name:WESTCOTT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2701 1ST AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1123
Mailing Address - Country:US
Mailing Address - Phone:206-448-2516
Mailing Address - Fax:206-448-6473
Practice Address - Street 1:550 17TH AVE
Practice Address - Street 2:SUITE 680
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5788
Practice Address - Country:US
Practice Address - Phone:206-215-4545
Practice Address - Fax:206-215-4550
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2020-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA12583207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0209229OtherL & I
WA1954106Medicaid
WAA05908Medicare UPIN
WA1954106Medicaid