Healthcare Provider Details

I. General information

NPI: 1730512682
Provider Name (Legal Business Name): JOSIAH NATHAN JOCO PEREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSIAH JOCO PEREZ MD

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 9TH AVE
SEATTLE WA
98101-2756
US

IV. Provider business mailing address

3181 SW SAM JACKSON PARK RD OHSU
PORTLAND OR
97239-3011
US

V. Phone/Fax

Practice location:
  • Phone: 206-223-6980
  • Fax: 206-223-6982
Mailing address:
  • Phone: 503-494-8220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD61145157
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA172733
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: