Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD00040101 | WA |
Y | 2080P0210X | Pediatric Nephrologist | MD00040101 | WA |
NPI | 1336218635 |
---|---|
Provider Name | Daryl M Okamura |
First Address | Seattle, WA 98105-1010 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 02/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8318347 | (05) | WA |
H67786 | (02) | WA |