MEDICARE: ANTONY JOSEPH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD61313407	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164579983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONY JOSEPH MD

Provider Business Mailing Address
First Line	:	1708 YAKIMA AVE STE 112
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-5300
Country	:	US
Telephone Number	:	253-382-8450
Fax Number	:	253-382-8125

Provider Business Practice Location Address
First Line	:	1708 YAKIMA AVE STE 112
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-5300
Country	:	US
Telephone Number	:	253-382-8450
Fax Number	:	253-382-8125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	01/27/2026

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Directions to “ ANTONY JOSEPH MD” Practice Location

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