Individual
BOSSAKARA SOKHOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
925 SENECA ST. MAILSTOP H8-GME, SEATTLE, WA 98101
(206) 583-6079
Mailing address
450 BROADWAY STREET, MC6343, REDWOOD CITY, CA 94063
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A196629
CA
207L00000X
Anesthesiology Physician
MD61547402
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2160283
—
WA
01
—
590889
LABOR & INDUSTRIES
WA
Enumeration date
05/01/2019
Last updated
09/27/2024
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