Basic Information
Provider Information
NPI: 1659344109
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOLOJAN
FirstName: JO-ANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 OLIVE WAY
Address2: MS: M4-PA
City: SEATTLE
State: WA
PostalCode: 981011873
CountryCode: US
TelephoneNumber: 2065155811
FaxNumber:  
Practice Location
Address1: 1100 9TH AVE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981012756
CountryCode: US
TelephoneNumber: 2062236600
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XRN00130942WAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

ID Information
IDTypeStateIssuerDescription
2055DO01WAINDIVIDUAL BLUE SHIELDOTHER
964259605WA MEDICAID
P0013583701WARAILROAD MEDICAREOTHER


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