Basic Information
| Provider Information | |||||||||
| NPI: | 1427180330 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KING | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | MAXWELL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11000 LAKE CITY WAY NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064613614 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11000 LAKE CITY WAY NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064613614 | ||||||||
| FaxNumber: | 8183760044 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 03/15/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225400000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.