Provider Demographics
NPI:1396907275
Name:OROZCO, JOHNNIE JOSE (MD)
Entity type:Individual
Prefix:
First Name:JOHNNIE
Middle Name:JOSE
Last Name:OROZCO
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 1:1100 FAIRVIEW AVE N # D3-190
Mailing Address - Street 2:PO BOX 19024
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4433
Mailing Address - Country:US
Mailing Address - Phone:206-667-4102
Mailing Address - Fax:206-667-1854
Practice Address - Street 1:1100 FAIRVIEW AVE N
Practice Address - Street 2:D3-190
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4433
Practice Address - Country:US
Practice Address - Phone:206-667-4102
Practice Address - Fax:206-667-1854
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103155207R00000X
WAMD60095720207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology