Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD00038510 | WA |
N | 207PE0004X | Emergency Medical Services | MD00038510 | WA |
NPI | 1205885373 |
---|---|
Provider Name | Aine Kelly Yore |
First Address | Everett, WA 98201-2098 |
Second Address | Everett, WA 98201-1689 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 08/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8257347 | (05) | WA |
H25189 | (02) | WA |