Provider Demographics
NPI:1982608253
Name:KRATZ, RODNEY JON (MD)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:JON
Last Name:KRATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MADISON ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1306
Mailing Address - Country:US
Mailing Address - Phone:206-386-6600
Mailing Address - Fax:206-386-2452
Practice Address - Street 1:1101 MADISON ST
Practice Address - Street 2:SUITE 500
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1306
Practice Address - Country:US
Practice Address - Phone:206-386-6600
Practice Address - Fax:206-386-2452
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052061A174400000X
WAMD00041005208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INH66123Medicare UPIN
IN563570EMedicare ID - Type Unspecified