Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 60016675 | WA |
N | 207VG0400X | Gynecologist | 60016675 | WA |
NPI | 1467544460 |
---|---|
Provider Name | Cynthia Mosbrucker |
First Address | Gig Harbor, WA 98335-2215 |
Second Address | Gig Harbor, WA 98335-2215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C09578 | (02) |