Healthcare Provider Details

I. General information

NPI: 1174545917
Provider Name (Legal Business Name): DAVID JAY HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 1ST AVE STE 900
SEATTLE WA
98121-2154
US

IV. Provider business mailing address

3833 N WINNIFRED ST
TACOMA WA
98407-2721
US

V. Phone/Fax

Practice location:
  • Phone: 206-374-1563
  • Fax:
Mailing address:
  • Phone: 406-208-6767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number60170584
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7324
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: