Provider Demographics
NPI:1518032374
Name:KOCSIS, AGNES BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:BARBARA
Last Name:KOCSIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 LINDEN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3231
Mailing Address - Country:US
Mailing Address - Phone:206-527-0247
Mailing Address - Fax:253-382-2091
Practice Address - Street 1:2209 E.32ND STR
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404
Practice Address - Country:US
Practice Address - Phone:253-593-0232
Practice Address - Fax:253-382-2091
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC000391422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA150778OtherLABOR & INDUSTRIES
WA1355KOOtherREGENCE
WA98404A030OtherTRICARE
WAH54971Medicare UPIN
WAAB26791Medicare ID - Type Unspecified