Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO60721876 | WA |
NPI | 1073931747 |
---|---|
Provider Name | Colyn Nouv |
First Address | Bellevue, WA 98006-3140 |
Second Address | Snoqualmie, WA 98065-5199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2014 |
Last Update Date | 22/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2082072 | (05) | WA |