MEDICARE: JOSEPH WALTER UPTON III MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	MD00032129	WA

General Provider Information

NPI Number	:	1255512885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH WALTER UPTON III MD

Provider Business Mailing Address
First Line	:	10047 MAIN ST
Second Line	:	STE 103
City	:	BELLEVUE
State	:	WA
Zip	:	98004-5322
Country	:	US
Telephone Number	:	425-861-6258
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 CENTRAL WAY
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98033-6106
Country	:	US
Telephone Number	:	425-300-6656
Fax Number	:	425-629-3065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2007
Last Update Date	:	08/28/2024

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