Provider Demographics
NPI:1891314118
Name:KO, HARAM (DDS)
Entity Type:Individual
Prefix:
First Name:HARAM
Middle Name:
Last Name:KO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 NE RAVENNA BLVD APT 303
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6578
Mailing Address - Country:US
Mailing Address - Phone:313-649-0624
Mailing Address - Fax:
Practice Address - Street 1:1416 NW 46TH ST STE 106
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4622
Practice Address - Country:US
Practice Address - Phone:206-783-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032841122300000X
WADE61377821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist