Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD00022153 | WA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | MD00022153 | WA |
NPI | 1932283652 |
---|---|
Provider Name | Carol A Mowery |
First Address | Seattle, WA 98105-3900 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 05/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1040351 | (05) | WA |
E 33752 | (02) | WA |