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General NPI Number Information
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NPI Number | 1508087669
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Entity Type | Individual
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Provider Name | JOHN D. PUTNAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/31/2009
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Provider Practice Location Address
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Address Line | 611 31ST AVE SW
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City | PUYALLUP
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State | WA
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Zip | 98373
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Country | US
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Telephone | 253-445-7100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34581
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City | SEATTLE
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State | WA
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Zip | 98124-1581
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Country | US
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Telephone | 509-241-7349
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Fax | 509-241-7628
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00016138
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | MD00016138
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License Number State | WA
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