Provider Demographics
NPI:1447230255
Name:OZGUR, HASAN TUNA (MD)
Entity Type:Individual
Prefix:DR
First Name:HASAN
Middle Name:TUNA
Last Name:OZGUR
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 1:700 LINCOLN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626-1057
Mailing Address - Country:US
Mailing Address - Phone:360-425-5131
Mailing Address - Fax:360-425-5509
Practice Address - Street 1:700 LINCOLN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-1057
Practice Address - Country:US
Practice Address - Phone:360-425-5131
Practice Address - Fax:360-425-5509
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000381292085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA133876OtherWASHINGTON L&I
WA8251118Medicaid
WA130336OtherOREGON DSHS
WAAB13931Medicare ID - Type Unspecified
WA8251118Medicaid