Individual
ANIFAT O. BALOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6850 35TH AVE NE, STE 4, SEATTLE, WA 98115-7344
(206) 525-0903
(866) 497-3901
Mailing address
6850 35TH AVE NE, STE 4, SEATTLE, WA 98115-7344
(206) 525-0903
(866) 497-3901
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD00039276
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5618BA
REGENCE
WA
01
—
611494859
TAX ID
WA
05
—
8264525
—
WA
Enumeration date
10/12/2005
Last updated
09/07/2012
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