Konstantin Koro, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

FE60762184 Issued in WA

Practice address

1959 NE Pacific Street, RM NE 110
University of Washington, Department of Pathology
Seattle, WA 98195

Phone

(206) 616-6961

NPI assigned

Jun 5, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Konstantin Viktorovitch Korotkov Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1770012619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC STREET, BOX 356100",
            "address_2": "UNIVERSITY OF WASHINGTON, DEPARTMENT OF PATHOLOGY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC STREET, RM NE 110",
            "address_2": "UNIVERSITY OF WASHINGTON, DEPARTMENT OF PATHOLOGY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98195",
            "telephone_number": "206-616-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORO",
        "first_name": "KONSTANTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "FE60762184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KONSTANTIN",
            "last_name": "KOROTKOV",
            "middle_name": "VIKTOROVITCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Barry John Kornegay, BCBA
• Kent Alan Korneisel, O.D.
• Helen Kornfeld
• Miriam Korngold, LMHCA
• Rebecca R Kornstedt, M.S.
• Katrina Korreckt
• Ashley Kortman, MS
• Chantelle Korver, DAOM, LAC, EAMP
• Jacqueline Kathleen Kosak
• Bradley William Kosel, PHARMD

• Student in an Organized Health Care Education/Training Program in Seattle, WA
• Providers in Seattle, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.