Provider Demographics
NPI:1275989881
Name:HUHNDORF, JOSH (MD)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:HUHNDORF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 TALBOT RD S
Mailing Address - Street 2:SUITE 401
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5738
Mailing Address - Country:US
Mailing Address - Phone:425-228-3440
Mailing Address - Fax:425-656-5395
Practice Address - Street 1:3915 TALBOT RD S
Practice Address - Street 2:SUITE 401
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5738
Practice Address - Country:US
Practice Address - Phone:425-228-3440
Practice Address - Fax:425-656-5395
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML60667481207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program