Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD38687 | WA |
NPI | 1003863697 |
---|---|
Provider Name | Norman C. Rokosz |
First Address | Vancouver, WA 98664-3299 |
Second Address | Vancouver, WA 98664-3299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 10/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8256257 | (05) | WA |
H20222 | (02) |