Provider Demographics
NPI:1023152642
Name:KOJIS, JOHN D (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:KOJIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:222 NE PARK PLAZA DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5895
Mailing Address - Country:US
Mailing Address - Phone:360-254-8866
Mailing Address - Fax:360-254-8028
Practice Address - Street 1:222 NE PARK PLAZA DR
Practice Address - Street 2:SUITE 114
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5895
Practice Address - Country:US
Practice Address - Phone:360-254-8866
Practice Address - Fax:360-254-8028
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WACH00001314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT61000Medicare UPIN
GAB21286Medicare PIN