Provider Demographics
NPI:1053406397
Name:O'CALLAGHAN, JAMES JOSEPH (MD, FAAP SFHM)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:O'CALLAGHAN
Suffix:
Gender:M
Credentials:MD, FAAP SFHM
Other - Prefix:
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Mailing Address - Street 1:4106 WALLINGFORD AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8221
Mailing Address - Country:US
Mailing Address - Phone:206-528-0604
Mailing Address - Fax:888-980-6067
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-8232
Practice Address - Fax:425-899-6605
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00040995208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8317299Medicaid
WA8317299Medicaid
I03732Medicare UPIN