Healthcare Provider Details

I. General information

NPI: 1538344676
Provider Name (Legal Business Name): HEALTHFORCE OCCUPATIONAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13033 BELLEVUE REDMOND RD # 110
BELLEVUE WA
98005-2633
US

IV. Provider business mailing address

11805 N CREEK PKWY S SUITE 113
BOTHELL WA
98011-8803
US

V. Phone/Fax

Practice location:
  • Phone: 425-468-6500
  • Fax: 425-468-6501
Mailing address:
  • Phone: 425-806-5700
  • Fax: 425-806-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. JACK L SIEMERING JR.
Title or Position: PRESIDENT
Credential:
Phone: 425-806-5720