Provider Demographics
NPI:1750802229
Name:POLLOCK, CODY DAVID (MD)
Entity type:Individual
Prefix:MR
First Name:CODY
Middle Name:DAVID
Last Name:POLLOCK
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 1:526 19TH AVE EAST
Mailing Address - Street 2:APARTMENT 301
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122
Mailing Address - Country:US
Mailing Address - Phone:903-640-3034
Mailing Address - Fax:
Practice Address - Street 1:1959 NORTHEAST PACIFIC STREET,
Practice Address - Street 2:BOX 357115 UNIVERSITY OF WASHINGTON MEDICAL CENTER
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115
Practice Address - Country:US
Practice Address - Phone:206-598-5130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program