Provider Demographics
NPI:1558504092
Name:ENGMAN, JOSEPH E (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:ENGMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16939 14TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3840
Mailing Address - Country:US
Mailing Address - Phone:206-999-4772
Mailing Address - Fax:206-546-0605
Practice Address - Street 1:16939 14TH AVE NW
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-3840
Practice Address - Country:US
Practice Address - Phone:206-999-4772
Practice Address - Fax:206-546-0605
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001064207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1558504092Medicaid
WAA06517OtherUPIN