Individual
DR. GRANT NORMAN KO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 POTTERY AVE, PORT ORCHARD, WA 98366-3711
(360) 895-5000
(360) 895-5034
Mailing address
1400 POTTERY AVE, PORT ORCHARD, WA 98366-3768
(360) 895-5000
(360) 895-5034
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
25MA06989400
NJ
2084P0800X
Psychiatry Physician
G49179
CA
2084P0800X
Psychiatry Physician
Primary
MD00024074
WA
2084P0800X
Psychiatry Physician
PT 12664
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17852
—
ND
Enumeration date
03/16/2007
Last updated
09/23/2022
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