Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD00013065 | WA |
NPI | 1336196955 |
---|---|
Provider Name | Daniel W Kozie |
First Address | Federal Way, WA 98003-8723 |
Second Address | Federal Way, WA 98003-6704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 28/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1427128198 | GROUP NPI (01) | WA |
A04926 | (02) |