Provider Demographics
NPI:1578503660
Name:FURUKAWA, CLIFTON T (MD)
Entity Type:Individual
Prefix:
First Name:CLIFTON
Middle Name:T
Last Name:FURUKAWA
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 1:9725 3RD AVE NE
Mailing Address - Street 2:#500
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2060
Mailing Address - Country:US
Mailing Address - Phone:206-527-1200
Mailing Address - Fax:206-523-0724
Practice Address - Street 1:9725 3RD AVE NE
Practice Address - Street 2:#500
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2060
Practice Address - Country:US
Practice Address - Phone:206-527-1200
Practice Address - Fax:206-523-0724
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00012176207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8156804Medicaid
WA030001510OtherRAILROAD MEDICARE
WA120835OtherCIGNA DMERC
WAF974OtherREGENCE RIDER
WA030004281OtherMEDICARE RAILROAD
WA030001510OtherRAILROAD MEDICARE
WA8156804Medicaid