Organization
RETINA INSTITUTE OF WASHINGTON PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE J. KO M.D. (MANAGING DIRECTOR)
(425) 228-6262
Entity
Organization
Contact information
Practice address
4300 TALBOT RD S STE 201, RENTON, WA 98055-6238
(206) 892-8281
Mailing address
4300 TALBOT RD S, STE 201, RENTON, WA 98055-6238
(425) 228-6262
(425) 228-6260
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD60021230
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205890514
NPI-INDIVIDUAL
—
01
—
MD60021230
WASHINGTON STATE PROFESSIONAL LICENSE
—
Enumeration date
12/10/2009
Last updated
07/27/2010
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