Healthcare Provider Details

I. General information

NPI: 1205918208
Provider Name (Legal Business Name): MICHAEL K HORI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 TALBOT RD S STE 570
RENTON WA
98055-5700
US

IV. Provider business mailing address

3600 LIND AVE SW SUITE 100 - ATTN: CREDENTIALING
RENTON WA
98057
US

V. Phone/Fax

Practice location:
  • Phone: 425-690-3487
  • Fax: 425-690-9087
Mailing address:
  • Phone: 425-690-2715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00021890
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD00021890
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: