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General NPI Number Information
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NPI Number | 1316119977
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Entity Type | Organization
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Legal Business Name | THEODORE J KAPANJIE DO PS
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 1530 N 115TH ST 302
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City | SEATTLE
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State | WA
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Zip | 98133-8421
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Country | US
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Telephone | 206-365-0660
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Fax |
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Provider Business Mailing Address
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Address Line | 1530 N 115TH ST 302
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City | SEATTLE
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State | WA
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Zip | 98133-8421
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Country | US
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Telephone | 206-365-0660
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | THEODORE JAMES KAPANJIE
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Credential |
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Telephone | 206-365-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP00001679
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License Number State | WA
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