Basic Information
| Provider Information | |||||||||
| NPI: | 1477715696 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | JOHNSON | ||||||||
| FirstName: | KAALAN | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 SAND POINT WAY NE | ||||||||
| Address2: | OA.9.220 - OTOLARYNGOLOGY-ENT | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981053901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069873468 | ||||||||
| FaxNumber: | 2069873925 | ||||||||
| Practice Location | |||||||||
| Address1: | 4800 SAND POINT WAY NE | ||||||||
| Address2: | OA.9.220 - OTOLARYNGOLOGY-ENT | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981053901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069873468 | ||||||||
| FaxNumber: | 2069873925 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2008 | ||||||||
| LastUpdateDate: | 07/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YP0228X | 35.097031 | OH | N | Allopathic & Osteopathic Physicians | Otolaryngology | Pediatric Otolaryngology | 207YP0228X | MD 60340296 | WA | Y | Allopathic & Osteopathic Physicians | Otolaryngology | Pediatric Otolaryngology |
No ID Information.