Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | MD00012576 | WA |
N | 207K00000X | Allergist & Immunologist | MD10203 | OR |
N | 207KA0200X | Allergist | MD00012576 | WA |
N | 207KA0200X | Allergist | MD10203 | OR |
N | 207N00000X | Dermatologist | MD00012576 | WA |
Y | 207N00000X | Dermatologist | MD10203 | OR |
N | 207ND0900X | Dermatopathologist | MD00012576 | WA |
N | 207ND0900X | Dermatopathologist | MD10203 | OR |
N | 207NS0135X | Procedural Dermatology | MD00012576 | WA |
N | 207NS0135X | Procedural Dermatology | MD10203 | OR |
NPI | 1023013984 |
---|---|
Provider Name | Dr. John A Kazmierowski |
First Address | Salem, OR 97302-2541 |
Second Address | Vancouver, WA 98686-3031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006833 | (05) | OR |
A08100 | (02) |