Provider Demographics
NPI:1255636783
Name:JURIC-SEKHAR, GORDANA (MD PHD)
Entity type:Individual
Prefix:DR
First Name:GORDANA
Middle Name:
Last Name:JURIC-SEKHAR
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE # 359791
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2420
Mailing Address - Country:US
Mailing Address - Phone:206-744-6776
Mailing Address - Fax:206-897-4688
Practice Address - Street 1:1959 NE PACIFIC ST BOX 356100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6100
Practice Address - Country:US
Practice Address - Phone:206-598-6400
Practice Address - Fax:206-598-3803
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD60451051207ZN0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1154332047Medicaid