Provider Demographics
NPI:1427180330
Name:KING, JOHN MAXWELL
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MAXWELL
Last Name:KING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 LAKE CITY WAY NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:206-461-3614
Mailing Address - Fax:
Practice Address - Street 1:11000 LAKE CITY WAY NE
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-461-3614
Practice Address - Fax:818-376-0044
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner