Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | DE60660417 | WA |
NPI | 1366867285 |
---|---|
Provider Name | Austin Gaal |
First Address | Kirkland, WA 98034-3051 |
Second Address | Kirkland, WA 98034-3051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2014 |
Last Update Date | 04/02/2019 |