Provider Demographics
NPI:1568537843
Name:KOCH, LLOYD FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:FRANK
Last Name:KOCH
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 1:11023 37TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-1740
Mailing Address - Country:US
Mailing Address - Phone:206-313-1636
Mailing Address - Fax:
Practice Address - Street 1:7935 216TH ST SW
Practice Address - Street 2:SUITE E
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7941
Practice Address - Country:US
Practice Address - Phone:425-672-2113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA34022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB28684Medicare ID - Type Unspecified
WAU90009Medicare UPIN