Healthcare Provider Details

I. General information

NPI: 1083696983
Provider Name (Legal Business Name): JEFFREY CAMERON HOFF D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13014 12TH AVE SW
BURIEN WA
98146-3110
US

IV. Provider business mailing address

13014 12TH AVE SW
BURIEN WA
98146-3110
US

V. Phone/Fax

Practice location:
  • Phone: 206-244-0867
  • Fax: 206-244-3151
Mailing address:
  • Phone: 206-244-9232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP00001072
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: