Provider Demographics
NPI:1437392479
Name:KO, JIA-WEI KEVIN (MD)
Entity Type:Individual
Prefix:MR
First Name:JIA-WEI
Middle Name:KEVIN
Last Name:KO
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 1:601 BROADWAY 6TH
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5330
Mailing Address - Country:US
Mailing Address - Phone:206-386-2600
Mailing Address - Fax:206-622-1644
Practice Address - Street 1:601 BROADWAY 6TH
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5330
Practice Address - Country:US
Practice Address - Phone:206-386-2600
Practice Address - Fax:206-622-1644
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD60549136207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program