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General NPI Number Information
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NPI Number | 1366749095
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Entity Type | Organization
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Legal Business Name | RAPHA CLINICS, INC
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Dates
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Enumeration Date | 02/15/2011
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Last Update Date | 02/15/2011
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Provider Practice Location Address
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Address Line | 1130 N 185TH ST STE 202
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City | SHORELINE
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State | WA
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Zip | 98133-4011
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Country | US
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Telephone | 206-542-1000
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Fax | 206-542-5353
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Provider Business Mailing Address
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Address Line | 1130 N 185TH ST STE 202
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City | SHORELINE
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State | WA
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Zip | 98133-4011
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Country | US
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Telephone | 206-542-1000
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Fax | 206-542-5353
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | JOHN Y JOO
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Credential | DPM
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Telephone | 206-542-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | PO00000700
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO00000700
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO00000700
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License Number State | WA
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