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General NPI Number Information
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NPI Number | 1386106557
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Entity Type | Individual
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Provider Name | JAMES HENELY WYKOWSKI MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 660 BANNOCK ST FL 5
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City | DENVER
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State | CO
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Zip | 80204-4506
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Country | US
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Telephone | 303-436-4949
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50095
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City | SEATTLE
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State | WA
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Zip | 98145-5095
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Country | US
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Telephone | 206-520-5700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD61204349
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | DR0070870
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License Number State | CO
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