Healthcare Provider Details

I. General information

NPI: 1598292807
Provider Name (Legal Business Name): PATTY FUMIYO FURUKAWA-STUTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 06/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33431 13TH PL S
FEDERAL WAY WA
98003-6357
US

IV. Provider business mailing address

401 5TH AVE STE 1000
SEATTLE WA
98104-1818
US

V. Phone/Fax

Practice location:
  • Phone: 206-477-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00058531
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: