Healthcare Provider Details

I. General information

NPI: 1780790469
Provider Name (Legal Business Name): AMIT JOSHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7203 129TH AVE SE STE 100
NEWCASTLE WA
98056-1412
US

IV. Provider business mailing address

PO BOX 34876
SEATTLE WA
98124-1876
US

V. Phone/Fax

Practice location:
  • Phone: 425-656-5406
  • Fax: 425-656-5040
Mailing address:
  • Phone: 425-656-5412
  • Fax: 425-656-4079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD000049077
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: