Individual
JOHN N DIACONOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PS
Contact information
Practice address
202 N DIVISION ST, STE 402, AUBURN, WA 98001-4939
(253) 833-8032
(253) 833-8081
Mailing address
202 N DIVISION ST, STE 402, AUBURN, WA 98001-4939
(253) 833-8032
(253) 833-8081
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD00018742
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0152713
LABOR AND INDUSTRIES
WA
01
—
0244706
STATE L&I
WA
01
—
0265721
STATE L&I
WA
05
—
1779008
—
WA
01
—
230000055
RAILROAD MEDICARE PIN
WA
01
—
CH9408
RR MEDICARE GROUP #
WA
Enumeration date
08/24/2006
Last updated
03/01/2011
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