Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD61153812 | WA |
NPI | 1194103101 |
---|---|
Provider Name | Charyse Diaz |
First Address | Charleston, SC 29412-2863 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2015 |
Last Update Date | 26/05/2021 |