Bak, John B

Bak, John B is an individual health care provider with primary practice located at 11307 Bridgeport Way Sw Ste 217 , Lakewood WA 98499-3024. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Bak, John B can be contacted via phone (253) 985-6134.

Contact Information

Primary practice address
11307 Bridgeport Way Sw Ste 217 Lakewood WA 98499-3024
Phone: (253) 985-6134
Fax: (253) 985-6137
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD00044997 Washington

Profile Details

NPI number 1063413938
LBN Legal business name Bak, John B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Nov 24th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063413938 NPPES
Washington Other 0261681 STATE L&I
Washington Other 0216025 STATE L&I
Washington Other 0261684 STATE L&I
Washington Other 0299315 STATE L&I
Washington MEDICAID 7077449 STATE L&I

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