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Individual

JOHN WILLIAM O'KANE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3850 MONTLAKE BLVD NE RM 148 B, ARENA/HEC EDMUNDSON PAVILLION, SEATTLE, WA 98195-0001
(206) 543-1552
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00033072
WA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD00033072
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0231684
L&I
WA
01
1581
INTERNAL ID-MOTOR VEHICLE ID
05
1912082736
WA
Enumeration date
10/27/2006
Last updated
09/27/2011
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