Provider Demographics
NPI:1609835214
Name:JOSEPH, FREDERIC B (MD)
Entity Type:Individual
Prefix:
First Name:FREDERIC
Middle Name:B
Last Name:JOSEPH
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 1:10700 MERIDIAN AVE N
Mailing Address - Street 2:STE 505
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9008
Mailing Address - Country:US
Mailing Address - Phone:206-365-4100
Mailing Address - Fax:206-368-6898
Practice Address - Street 1:1550 N 115TH
Practice Address - Street 2:NORTHWEST HOSPITAL
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-368-1744
Practice Address - Fax:206-368-1398
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000403762085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7822109Medicaid
WE4663OtherREGENCE
WA0151260OtherA & I
WA300125606OtherRAILROAD
WA55900OtherA & I
7098660OtherAETNA
2415J0OtherREGENCE
4159J0OtherREGENCE
WA8284176Medicaid
WA7822109Medicaid
G47613Medicare UPIN
WAAB24430Medicare ID - Type Unspecified