Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic |
NPI | 1245718691 |
---|---|
Provider Name | Artansia Washington |
First Address | Stockton, CA 95203-2433 |
Second Address | Stockton, CA 95203-2433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2018 |
Last Update Date | 29/07/2018 |