Provider Demographics
NPI:1689054264
Name:RAGOZA, YURY (DO)
Entity type:Individual
Prefix:
First Name:YURY
Middle Name:
Last Name:RAGOZA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 731912
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1912
Mailing Address - Country:US
Mailing Address - Phone:903-877-7200
Mailing Address - Fax:903-877-5080
Practice Address - Street 1:17181 REDMOND WAY STE 300
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4441
Practice Address - Country:US
Practice Address - Phone:425-467-3655
Practice Address - Fax:425-635-7920
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10053887207Q00000X
TXR1854207Q00000X
WAOP61614616207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine