Individual
GLENN DAVID YOCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5407 17TH AVE NW, SEATTLE, WA 98107-3818
(206) 784-2670
(206) 784-1590
Mailing address
5407 17TH AVE NW, SEATTLE, WA 98107-3818
(206) 784-2670
(206) 784-1590
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000223
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00528
BLUE CROSS BLUE SHIELD
WA
05
—
1144401
—
WA
01
—
G000105970
PTAN
WA
01
—
YO0026
REGENCE BLUE SHIELD
WA
Enumeration date
03/22/2007
Last updated
09/02/2015
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