Healthcare Provider Details

I. General information

NPI: 1750472577
Provider Name (Legal Business Name): HEALTHFORCE OCCUPATIONAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3223 1ST AVE S SUITE 'C'
SEATTLE WA
98134-1850
US

IV. Provider business mailing address

18323 BOTHELL EVERETT HWY SUITE 220
BOTHELL WA
98012-5246
US

V. Phone/Fax

Practice location:
  • Phone: 206-624-3651
  • Fax: 206-624-2391
Mailing address:
  • Phone: 425-806-5700
  • Fax: 425-806-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberMD00031471
License Number StateWA

VIII. Authorized Official

Name: MR. JAMES JOSEPH LONG
Title or Position: CREDENTAILING
Credential:
Phone: 425-806-5700