Provider Demographics
NPI:1174545917
Name:HOFFMAN, DAVID JAY (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAY
Last Name:HOFFMAN
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 1:3833 N WINNIFRED ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-2721
Mailing Address - Country:US
Mailing Address - Phone:406-208-6767
Mailing Address - Fax:
Practice Address - Street 1:2025 1ST AVE STE 900
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2154
Practice Address - Country:US
Practice Address - Phone:206-374-1563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60170584207Q00000X
MT7324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT05481OtherBLUE CROSS BLUE SHIELD MT
MT980759Medicaid
F45615Medicare UPIN