Basic Information
| Provider Information | |||||||||
| NPI: | 1497792741 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOHONOS | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 9TH AVE | ||||||||
| Address2: | MS:M4-PFS | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981012756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065155811 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 925 SENECA ST | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981012742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065836450 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 04/28/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 00036694 | WA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 930122493 | 01 | WA | RAILROAD MC VM | OTHER | A018 | 01 | CHAMPUS | OTHER | G38463 | 01 | GROUP HEALTH | OTHER | MD8334W | 05 | AK | MEDICAID | 8231912 | 05 | WA | MEDICAID | 910861251 | 01 | PREMERA BC | OTHER | 9798BO | 01 | WA | BLUE SHIELD VM | OTHER | US5508305 | 01 | WA | AETNA SPECIALIST PIN VM | OTHER | 168557 | 01 | WA L & I | OTHER | 4472BO | 01 | REGENCE BS | OTHER | 930111866 | 01 | RAILROAD | OTHER |