Doctor Name: | RICHARD WESLEY KOSS |
NPI Number: | 1871646075 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | OP000989 |
Business Practice Address: | 22142 Se 237th St. Suite #8 Maple Valley, WA - 980386405 |
Business Phone Number: | 4254336073 |
Business Fax Number: | 4254336074 |
Mailing Address: | 22142 Se 237th St., Suite #8 MAPLE VALLEY |
State: | WA |
Postal Code: | 980386405 |
Phone Number: | 4254336073 |
Fax Number: | 4254336074 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 12/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | OP000989 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |