Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP30007501 | WA |
NPI | 1023104189 |
---|---|
Provider Name | Allison Meade |
First Address | Vancouver, WA 98664-1913 |
Second Address | Vancouver, WA 98664-1913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 12/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9650375 | (05) | WA |