MEDICARE: JOHNNIE JOSE OROZCO 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	207R00000X	Internal Medicine Physician	A103155	CA
2	207RH0003X	Hematology & Oncology Physician	MD60095720	WA

General Provider Information

NPI Number	:	1396907275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNNIE JOSE OROZCO MD

Provider Business Mailing Address
First Line	:	1100 FAIRVIEW AVE N # D3-190
Second Line	:	PO BOX 19024
City	:	SEATTLE
State	:	WA
Zip	:	98109-4433
Country	:	US
Telephone Number	:	206-667-4102
Fax Number	:	206-667-1854

Provider Business Practice Location Address
First Line	:	1100 FAIRVIEW AVE N
Second Line	:	D3-190
City	:	SEATTLE
State	:	WA
Zip	:	98109-4433
Country	:	US
Telephone Number	:	206-667-4102
Fax Number	:	206-667-1854

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

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	05/08/2014

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