Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD00010538 | WA |
Y | 111NI0900X | Internist | MD00010538 | WA |
N | 207RG0100X | Gastroenterologist | MD00010538 | WA |
NPI | 1043375199 |
---|---|
Provider Name | Charles M. Janeway |
First Address | Seattle, WA 98124-1581 |
Second Address | Seattle, WA 98112-5211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 12/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
233130 | L&I (01) | WA |
8447708 | (05) | WA |
A06315 | (02) | WA |