Basic Information
Provider Information
NPI: 1740366558
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABKOWITZ
FirstName: JANIS
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 50095
Address2:  
City: SEATTLE
State: WA
PostalCode: 981455095
CountryCode: US
TelephoneNumber: 2065436420
FaxNumber:  
Practice Location
Address1: SEATTLE CANCER CARE ALLIANCE
Address2: 825 EASTLAKE AVENUE EAST
City: SEATTLE
State: WA
PostalCode: 98109
CountryCode: US
TelephoneNumber: 2062881012
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/27/2006
LastUpdateDate: 02/14/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XMD00018607WAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
266401 INTERNAL ID-MOTOR VEHICLE IDOTHER
023061601WAL&IOTHER
174036655805WA MEDICAID


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