Healthcare Provider Details

I. General information

NPI: 1447868823
Provider Name (Legal Business Name): JANET OLUWOLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date: 08/27/2020
Reactivation Date: 07/20/2021

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone: 206-520-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD.MD.70114390
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: