Healthcare Provider Details

I. General information

NPI: 1730599572
Provider Name (Legal Business Name): FUMI OBUSE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FUMIKO NAUGHTON D.O.

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 09/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21600 HIGHWAY 99 STE 240
EDMONDS WA
98026-5139
US

IV. Provider business mailing address

10612 NE 18TH ST
BELLEVUE WA
98004-2817
US

V. Phone/Fax

Practice location:
  • Phone: 425-673-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP60639445
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOP60639445
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: