Healthcare Provider Details

I. General information

NPI: 1154384360
Provider Name (Legal Business Name): JEFFREY L FOTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 06/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105
US

IV. Provider business mailing address

PO BOX 5371
SEATTLE WA
98145-5005
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-6112
  • Fax: 206-987-3201
Mailing address:
  • Phone: 206-987-6112
  • Fax: 206-987-3201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD60217740
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: