Provider Demographics
NPI:1750086724
Name:KJOS, NILS (MD)
Entity type:Individual
Prefix:DR
First Name:NILS
Middle Name:
Last Name:KJOS
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 1:6308 SE 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2010
Mailing Address - Country:US
Mailing Address - Phone:206-948-1797
Mailing Address - Fax:
Practice Address - Street 1:850 REPUBLICAN ST # 358047
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4725
Practice Address - Country:US
Practice Address - Phone:206-221-1452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program