Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD60564654 | WA |
N | 207YP0228X | Pediatric Otolaryngology | MD60564654 | WA |
NPI | 1023218617 |
---|---|
Provider Name | Dr. Jonathan Chaim Kopelovich |
First Address | Seattle, WA 98104-1172 |
Second Address | Bellevue, WA 98004-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 17/08/2015 |