=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144525767
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 5FOCUS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2011
-----------------------------------------------------
Last Update Date | 01/12/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1009 8TH AVE N
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98109-3504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-631-2818
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1009 8TH AVE N
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98109-3504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-631-2818
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JEFF ROBINSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 206-631-2818
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number | PT00010035
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------