Provider Demographics
NPI:1962457549
Name:SOKOLOFF, MICHAEL JON (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JON
Last Name:SOKOLOFF
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:PO BOX 84301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5601
Mailing Address - Country:US
Mailing Address - Phone:509-474-4761
Mailing Address - Fax:509-474-4239
Practice Address - Street 1:101 W 8TH AVE
Practice Address - Street 2:ATTN: PICU
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2307
Practice Address - Country:US
Practice Address - Phone:509-474-4761
Practice Address - Fax:509-474-4239
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD601228122080P0203X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8567562OtherWA DS ANES
ID808621400OtherID DSHS
WA8566028OtherWA DSHS REG