Tavis Dickerson-young

MD | Pediatric Emergency Medicine | Male

---

Complete Profile:

Tavis Dickerson-young basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Emergency Medicine
Provider Name :	Tavis Dickerson-young
Credential :	MD
Gender :	Male

Business Address:

Tavis Dickerson-young address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	4800 Sand Point Way Ne # Mb.7.520 Seattle, WA, 98105-3901 United States
Phone Number :	206-987-2599

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1689092363
NPI Entity Type :	Individual
First Enrolment Date :	31 Mar, 2014
Last Updated On :	18 Aug, 2021

Medicare Participation:

Tavis Dickerson-young participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	3577883727
Medicare Enrollment ID :	I20170411001561
Primary Specialty :	Pediatric Medicine
Medical School :	University Of Southern California Keck School Of Medicine
Graduation Year :	2014
Accepts Medicare?	Yes. Tavis Dickerson-young accepts medicare insurance.

Group Practice Association:

Tavis Dickerson-young is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Tavis Dickerson-young is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
The Association Of Chrmc And University Physicians	9133032964	209	4800 Sand Point Way Ne Seattle, WA - 981053901 Ph: 2065262000	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Tavis Dickerson-young are as mentioned. Primary taxonomy code for Tavis Dickerson-young, MD is 2080P0204X (Pediatrics Pediatric Emergency Medicine).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	No	MD60741027	WA
2080P0204X	Pediatrics Pediatric Emergency Medicine	Yes	MD60741027	WA

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	4800 Sand Point Way Ne, Mailstop Mb.7.520 Seattle, WA, 98105-3901 United States

Business Location:

Patients can refer following map for directions to Tavis Dickerson-young practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.