Provider Demographics
NPI:1215207204
Name:DR. ALEX K OH, PS
Entity type:Organization
Organization Name:DR. ALEX K OH, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-250-3095
Mailing Address - Street 1:2821 NORTHUP WAY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1437
Mailing Address - Country:US
Mailing Address - Phone:425-250-3095
Mailing Address - Fax:425-250-3097
Practice Address - Street 1:2821 NORTHUP WAY
Practice Address - Street 2:SUITE 225
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1437
Practice Address - Country:US
Practice Address - Phone:425-250-3095
Practice Address - Fax:425-250-3097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH3151261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB00009Medicare UPIN