Provider Demographics
NPI:1184406605
Name:MARKOKAJ, REALD (DC)
Entity type:Individual
Prefix:DR
First Name:REALD
Middle Name:
Last Name:MARKOKAJ
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 1:102 BELLFLOWER RD
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-9162
Mailing Address - Country:US
Mailing Address - Phone:206-605-9188
Mailing Address - Fax:
Practice Address - Street 1:4236 36TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1312
Practice Address - Country:US
Practice Address - Phone:206-723-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61488221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACH61488221OtherCHIROPRACTIC LICENSE NUMBER