Organization
HEART CLINIC OF TACOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS CHARLES KOUKOL M.D. (PRESIDENT)
(253) 279-3487
Entity
Organization
Contact information
Practice address
120 STATE AVE NE #122, OLYMPIA, WA 98501
(253) 279-3487
Mailing address
120 STATE AVE NE #122, OLYMPIA, WA 98501
(253) 279-3487
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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