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Individual

STEVEN MAKOTO KODAMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-4101
(253) 426-6250
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00042416
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0172723
LIWA
WA
01
2165KO
BSWA
WA
05
8363418
WA
Enumeration date
06/09/2006
Last updated
03/07/2008
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