Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 60562639 | WA |
NPI | 1649655762 |
---|---|
Provider Name | Basil Abuid |
First Address | Mount Vernon, WA 98273-5454 |
Second Address | Mount Vernon, WA 98273-5454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2015 |
Last Update Date | 17/04/2019 |