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Individual

GAVRIEL DAVID KOHLBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-3722
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD60939547
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376867929
WA
Enumeration date
03/24/2010
Last updated
08/16/2019
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