Healthcare Provider Details

I. General information

NPI: 1568772556
Provider Name (Legal Business Name): PATRICK N OKOYE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 NW 3RD CT
RENTON WA
98057-3400
US

IV. Provider business mailing address

612 NW 3RD CT
RENTON WA
98057-3400
US

V. Phone/Fax

Practice location:
  • Phone: 206-931-9492
  • Fax: 206-722-2022
Mailing address:
  • Phone: 206-931-9492
  • Fax: 206-722-2022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: