Provider Demographics
NPI:1487846457
Name:O'NEILL, JOSEPH PATRICK
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21638 MARINE VIEW DR S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6154
Mailing Address - Country:US
Mailing Address - Phone:206-592-9521
Mailing Address - Fax:
Practice Address - Street 1:21638 MARINE VIEW DR S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6154
Practice Address - Country:US
Practice Address - Phone:206-592-9521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA643237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA122157OtherLABOR AND INDUSTRIES
WA0147948138OtherHEAR PO
WA9046012Medicaid