Healthcare Provider Details

I. General information

NPI: 1306109772
Provider Name (Legal Business Name): LUKA VLAHOVIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E JEFFERSON ST STE A1
SEATTLE WA
98122-5643
US

IV. Provider business mailing address

PO BOX 25608
SALT LAKE CITY UT
84125-0608
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-2200
  • Fax: 206-320-2560
Mailing address:
  • Phone: 206-320-4476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD70073580
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: