Healthcare Provider Details

I. General information

NPI: 1710819875
Provider Name (Legal Business Name): JOSHUA DAVID GREEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 16TH AVE E
SEATTLE WA
98112-5226
US

IV. Provider business mailing address

201 16TH AVE E
SEATTLE WA
98112-5226
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-4545
  • Fax: 206-326-4555
Mailing address:
  • Phone: 206-326-4545
  • Fax: 206-326-4555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License NumberRN00162625
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: