Provider Demographics
NPI:1194933010
Name:KOZY, JOHN SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SCOTT
Last Name:KOZY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14208 NW 3RD CT
Mailing Address - Street 2:#1
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-5789
Mailing Address - Country:US
Mailing Address - Phone:360-571-3464
Mailing Address - Fax:360-571-5675
Practice Address - Street 1:14208 NW 3RD CT
Practice Address - Street 2:#1
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-5789
Practice Address - Country:US
Practice Address - Phone:360-571-3464
Practice Address - Fax:360-571-5675
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0111017OtherLABOR & INDUSTRIES