Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD61095333 | WA |
N | 111NI0900X | Internist | MD61095333 | WA |
Y | 207RI0200X | Infectious Disease | MD61095333 | WA |
NPI | 1023403052 |
---|---|
Provider Name | Asa Lyman Tapley |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2015 |
Last Update Date | 30/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023403052 | (05) | WA |