MEDICARE: DARLA M. KLOKEID M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD00039069	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699745687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLA M. KLOKEID M.D.

Provider Business Mailing Address
First Line	:	130 SUTTER ST FL 2
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-4009
Country	:	US
Telephone Number	:	415-658-6791
Fax Number	:	415-520-0904

Provider Business Practice Location Address
First Line	:	1600 7TH AVE STE 110
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-2284
Country	:	US
Telephone Number	:	206-267-4390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	05/18/2017

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