Healthcare Provider Details

I. General information

NPI: 1922072396
Provider Name (Legal Business Name): JOSEPH THOMAS PALERMO JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 12/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10564 - 5TH AVE NE #201
SEATTLE WA
98125
US

IV. Provider business mailing address

10564 - 5TH AVE NE #201
SEATTLE WA
98125
US

V. Phone/Fax

Practice location:
  • Phone: 206-367-1222
  • Fax: 206-364-2664
Mailing address:
  • Phone: 206-367-1222
  • Fax: 206-364-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberOP0836
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOP00000836
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: