Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | MD00036994 | WA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD00036994 | WA |
NPI | 1114031853 |
---|---|
Provider Name | David F Pratt |
First Address | Everett, WA 98201-4989 |
Second Address | Everett, WA 98201-4989 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 21/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1110840 | (05) | WA |
126774 | L AND I (01) | WA |
G13846 | (02) |