Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | OP00001936 | WA |
NPI | 1043324130 |
---|---|
Provider Name | Christopher Philip Nyte |
First Address | Maple Valley, WA 98038-5155 |
Second Address | Maple Valley, WA 98038-5155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 28/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G65585 | (02) | WA |