Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD00031731 | WA |
NPI | 1114959293 |
---|---|
Provider Name | Alfred Higgins |
First Address | Wenatchee, WA 98801-2028 |
Second Address | Wenatchee, WA 98801-2028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 06/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
39556 | L&I (01) | WA |
8015687 | (05) | WA |
B92680 | (02) | WA |