| NPI | 1215150313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER P IEROKOMOS President 360-423-0960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: WA MD00022010) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD00022010) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WA MD00022010) | |
| 207YS0012X Otolaryngology, Sleep Medicine (Licence: WA MD00022010) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WA MD00022010) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WA MD00022010) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WA MD00022010) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |