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General NPI Number Information
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NPI Number | 1174649727
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Entity Type | Individual
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Provider Name | GLENN DAVID YOCUM DPM
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 5407 17TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-3818
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Country | US
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Telephone | 206-784-2670
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Fax | 206-784-1590
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Provider Business Mailing Address
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Address Line | 5407 17TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-3818
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Country | US
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Telephone | 206-784-2670
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Fax | 206-784-1590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO00000223
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License Number State | WA
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