MEDICARE: JOHN D LOESER

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	207T00000X	Neurological Surgery Physician	MD00009034	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0231440	OTHER	WA	L&I
2	4071	OTHER		INTERNAL ID-MOTOR VEHICLE ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770668584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN D LOESER

Provider Business Mailing Address
First Line	:	PO BOX 50095
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98145-5095
Country	:	US
Telephone Number	:	206-543-6420
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIVERSITY OF WASHINGTON MEDICAL CTR
Second Line	:	1959 NE PACIFIC ST
City	:	SEATTLE
State	:	WA
Zip	:	98195-6470
Country	:	US
Telephone Number	:	206-598-5637
Fax Number	:

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	12/31/2012

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