Healthcare Provider Details

I. General information

NPI: 1801442785
Provider Name (Legal Business Name): JOSEPH STARZL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 15TH AVE SW STE 100
SEATTLE WA
98106-2576
US

IV. Provider business mailing address

1202 RUCKER AVE
EVERETT WA
98201-1519
US

V. Phone/Fax

Practice location:
  • Phone: 206-965-1000
  • Fax:
Mailing address:
  • Phone: 425-789-7790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA61133642
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: