Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD60287265 | WA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD60287265 | WA |
N | 207R00000X | Internist | MD60287265 | WA |
N | 111NI0900X | Internist | MD60287265 | WA |
N | 207RH0002X | Hospice and Palliative Medicine | MD60287265 | WA |
N | 208D00000X | General Practice Physician | N/A | ZZ |
NPI | 1548416670 |
---|---|
Provider Name | Arun Vijay |
First Address | Tacoma, WA 98405-4234 |
Second Address | Tacoma, WA 98405-4234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2008 |
Last Update Date | 06/08/2012 |