Provider Demographics
NPI:1700843976
Name:JOOS, PAUL NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:NORMAN
Last Name:JOOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 TALBOT RD S
Mailing Address - Street 2:#210
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5773
Mailing Address - Country:US
Mailing Address - Phone:425-255-4250
Mailing Address - Fax:425-271-3294
Practice Address - Street 1:4011 TALBOT RD S
Practice Address - Street 2:#210
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5773
Practice Address - Country:US
Practice Address - Phone:425-255-4250
Practice Address - Fax:425-271-3294
Is Sole Proprietor?:No
Enumeration Date:2006-04-29
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016846174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1476308Medicaid
102602Medicare PIN
A04837Medicare UPIN