Provider Demographics
NPI:1073723946
Name:STOJAKOVIC, MILAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MILAN
Middle Name:
Last Name:STOJAKOVIC
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 13TH ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2000
Mailing Address - Country:US
Mailing Address - Phone:360-568-3121
Mailing Address - Fax:360-568-9334
Practice Address - Street 1:1207 13TH ST
Practice Address - Street 2:SUITE G
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2000
Practice Address - Country:US
Practice Address - Phone:360-568-3121
Practice Address - Fax:360-568-9334
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH33870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU83836Medicare UPIN
WAG8854256Medicare ID - Type UnspecifiedPRACTICE MEDICARE ID
WAG8854257Medicare ID - Type UnspecifiedPROVIDER MEDICARE ID