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DR. GARY FUDEM M.D.
NPI 1336123454
Surgery - Plastic and Reconstructive Surgery in Seattle, WA

Active since December 01, 2005
325 9TH AVE, DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERY, SEATTLE, WA 98104(206) 744-5735 Get Directions Write a Review

NPPES record last updated: December 17, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Gary Fudem M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GARY FUDEM M.D. (NPI 1336123454) is an individual plastic and reconstructive surgery provider in Seattle, Washington, licensed in Washington (MD60484351) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1336123454
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameDR. GARY FUDEMCredential: M.D.
Location Address325 9TH AVE, DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERYSeattle, WA 98104-2420
Mailing AddressPo Box 50095Seattle, WA 98145-5095 · (206) 543-6420
Phone(206) 744-5735
Sole ProprietorNo
Enumeration DateDecember 1, 2005
Last NPPES UpdateDecember 17, 2014
✔ NPI 1336123454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in WA · MD60484351
Definition

A surgeon who specializes in plastic and reconstructive surgery.

325 9TH AVE, Seattle, WA 98104
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Other Identifiers 2

Medicaid1336123454WA
Medicare PIN8934503WA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDRA K WALKER ARNP
Nurse Practitioner (Acute Care)
325 9TH AVE
SEATTLE, WA 98104
King County (206) 598-0502
JULIA J VISSER DPT
Physical Therapist
325 9TH AVE, BOX 359920
SEATTLE, WA 98104
King County (206) 744-1675
GENIA J MONCADA
Pharmacist
325 9TH AVE, MAILSTOP 359912
SEATTLE, WA 98104
King County (206) 731-3219
JACQUELINE M. KIM LICSW, MSW
Social Worker (Clinical)
325 9TH AVE, BOX 359760
SEATTLE, WA 98104
King County (206) 744-8511
MS. DIANE E WHEELER MS, PA-C
Physician Assistant (Medical)
325 9TH AVE
SEATTLE, WA 98104
King County (206) 744-3000
AMELIA V. RIVERA
Physical Therapist
325 9TH AVE
SEATTLE, WA 98104
King County (206) 774-3300
TIMOTHY WILLIAM MENZA MD, PHD
Internal Medicine (Infectious Disease)
325 9TH AVE
SEATTLE, WA 98104
King County (206) 520-5000
DEMETRIOS TEREZAKIS
Occupational Therapist
325 9TH AVE
SEATTLE, WA 98104
King County (206) 744-6112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Fudem's NPI number?

The NPI number for Gary Fudem is 1336123454. It was assigned to this individual provider in the NPPES registry on December 1, 2005.

Where is Gary Fudem located?

Gary Fudem practices at 325 9th Ave Department Of Plastic & Reconstructive Surgery, Seattle, WA 98104. The listed phone number is (206) 744-5735.

What is Gary Fudem's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

When was this NPI record last updated?

The NPPES record for Gary Fudem was last updated on December 17, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.