| Doctor Name: | RAFAEL PUTNAM |
| NPI Number: | 1063836021 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RT/R |
| License Number: | 60062042 |
| Business Practice Address: | 2700 Nw Pine Cone Dr #103 Issaquah, WA - 980278663 |
| Business Phone Number: | 5053074798 |
| Business Fax Number: | |
| Mailing Address: | 2700 Nw Pine Cone Dr, #103 ISSAQUAH |
| State: | WA |
| Postal Code: | 980278663 |
| Phone Number: | 5053074798 |
| Fax Number: | |
| NPI Enumeration Date: | 02/11/2014 |
| NPI Last Update Date: | 02/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C1101X |
| License Number: | 60062042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Cardiovascular-Interventional Technology |
| Taxonomy Definition: | |