Provider Demographics
NPI:1255512885
Name:UPTON, JOSEPH WALTER III (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WALTER
Last Name:UPTON
Suffix:III
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 1:10047 MAIN ST
Mailing Address - Street 2:STE 103
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5322
Mailing Address - Country:US
Mailing Address - Phone:425-861-6258
Mailing Address - Fax:
Practice Address - Street 1:140 CENTRAL WAY
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6106
Practice Address - Country:US
Practice Address - Phone:425-300-6656
Practice Address - Fax:425-629-3065
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032129208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice