Healthcare Provider Details

I. General information

NPI: 1053406397
Provider Name (Legal Business Name): JAMES JOSEPH O'CALLAGHAN MD, FAAP SFHM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 04/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4106 WALLINGFORD AVE N
SEATTLE WA
98103-8221
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-8232
  • Fax: 425-899-6605
Mailing address:
  • Phone: 206-528-0604
  • Fax: 888-980-6067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00040995
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: