Healthcare Provider Details

I. General information

NPI: 1003011933
Provider Name (Legal Business Name): PATRICK T. HURLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19020 33RD AVE W SUITE 210
LYNNWOOD WA
98036-4748
US

IV. Provider business mailing address

19020 33RD AVE W SUITE 210
LYNNWOOD WA
98036-4748
US

V. Phone/Fax

Practice location:
  • Phone: 425-563-1500
  • Fax: 425-563-1501
Mailing address:
  • Phone: 425-563-1500
  • Fax: 425-563-1374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberEMC0001581
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number23852
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD00049440
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: