Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 2315 | WA |
NPI | 1316006349 |
---|---|
Provider Name | Dr. Stephen James Zografos |
First Address | Kent, WA 98042-5139 |
Second Address | Kent, WA 98030-2819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U24510 | (02) |