Provider Demographics
NPI:1184903098
Name:VAN HOY, JOHN MARSHALL (LMP, EAMP)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MARSHALL
Last Name:VAN HOY
Suffix:
Gender:M
Credentials:LMP, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 DELRIDGE WAY SW APT 22B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-3415
Mailing Address - Country:US
Mailing Address - Phone:206-669-1285
Mailing Address - Fax:
Practice Address - Street 1:7901 DELRIDGE WAY SW APT 22B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-3415
Practice Address - Country:US
Practice Address - Phone:206-669-1285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC0000761171100000X
WAMA5412225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturist