Individual ProviderJerry S KohInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1321 Colby Ave, Everett, WA 98201-1665(425) 261-2000(866) 747-2455PECOS EnrollmentThis provider is enrolled in PECOS as JERRY KOH.Based on the most recent information from CMS, provider Jerry S Koh is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1881705200Provider TypeIndividualFull NameKoh, Jerry SCredentialMDGenderMaleSole ProprietorNoEnumeration Date8/31/2006Last Updated3/29/2021Contact InformationPractice LocationPractice Address1321 Colby Ave, Everett, WA 98201-1665Phone(425) 261-2000FaxUnlisted FaxMailing LocationMailing AddressPO Box 3360, Portland, OR 97208-3360Phone(866) 747-2455FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseMD00045296WashingtonCode208M00000XDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseMD00045296WashingtonCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense45296WashingtonProvider IdentifiersIDDescriptionIssuerIDMD00045296DescriptionOtherIssuerLICENSEWashington