Provider Demographics
NPI:1700852092
Name:OZOLIN, ARTHUR J (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:J
Last Name:OZOLIN
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 1:2420 S UNION
Mailing Address - Street 2:STE 300
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1387
Mailing Address - Country:US
Mailing Address - Phone:253-756-0723
Mailing Address - Fax:253-752-1704
Practice Address - Street 1:2420 S UNION
Practice Address - Street 2:STE 300
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1387
Practice Address - Country:US
Practice Address - Phone:253-756-0888
Practice Address - Fax:253-752-1704
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00012234207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0256313OtherSTATE L&I
WA1657006Medicaid
WA0256771OtherSTATE L&I
A08555Medicare UPIN
WA001000872Medicare ID - Type Unspecified
WA1657006Medicaid