Provider Demographics
NPI:1407846504
Name:KLOSS, HERBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:
Last Name:KLOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5908
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-0408
Mailing Address - Country:US
Mailing Address - Phone:206-244-1212
Mailing Address - Fax:206-244-1223
Practice Address - Street 1:5057 84TH AVE SE
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-4617
Practice Address - Country:US
Practice Address - Phone:206-244-1212
Practice Address - Fax:206-244-1223
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00017372207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0139716OtherDEPT OF LABOR & INDUSTRIE
WAP00113699OtherRAILROAD MEDICARE
WA1055268Medicaid
WA9638KLOtherREGENCE BLUE SHIELD
WAGAB15777Medicare ID - Type UnspecifiedKING COUNTY WA
WAP00113699OtherRAILROAD MEDICARE
WA0139716OtherDEPT OF LABOR & INDUSTRIE