Provider Demographics
NPI:1922058676
Name:KOZINSKI, MALGORZATA I (MD)
Entity Type:Individual
Prefix:DR
First Name:MALGORZATA
Middle Name:I
Last Name:KOZINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MALGORZATA
Other - Middle Name:I
Other - Last Name:KOZINSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 NE MOTHER JOSEPH PL
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-3299
Mailing Address - Country:US
Mailing Address - Phone:360-256-5640
Mailing Address - Fax:360-260-7288
Practice Address - Street 1:200 NE MOTHER JOSEPH PL
Practice Address - Street 2:SUITE 400
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3299
Practice Address - Country:US
Practice Address - Phone:360-256-5640
Practice Address - Fax:360-260-7288
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045967207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease