Basic Information
| Provider Information | |||||||||
| NPI: | 1336148584 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANCOCK | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 389674 MSC 18913 | ||||||||
| Address2: | |||||||||
| City: | TUKWILA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981389674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606582700 | ||||||||
| FaxNumber: | 3606585091 | ||||||||
| Practice Location | |||||||||
| Address1: | 10330 MERIDIAN AVE N | ||||||||
| Address2: | #370 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981339451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065286000 | ||||||||
| FaxNumber: | 2065280014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | MD00011618 | WA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 1345107 | 05 | WA | MEDICAID |