Individual
JOHN R. OVERBECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4803 55TH AVE S, SEATTLE, WA 98118-1518
(206) 579-8871
Mailing address
4803 55TH AVE S, SEATTLE, WA 98118-1518
(206) 579-8871
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
24396
HI
207UN0901X
Nuclear Cardiology Physician
MD00035253
WA
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
MD00035253
WA
2085N0904X
Nuclear Radiology Physician
MD455386
PA
208D00000X
General Practice Physician
MD00035253
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130268
L&I PROVIDER NUMBER
WA
01
—
175496
L&I PROVIDER NUMBER
WA
05
—
8234643
—
WA
Enumeration date
01/05/2006
Last updated
11/21/2024
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