Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD00038476 | WA |
N | 207RC0200X | Critical Care Medicine | MD00038476 | WA |
N | 207RP1001X | Pulmonary Disease | MD00038476 | WA |
NPI | 1003844713 |
---|---|
Provider Name | David J Carlbom |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 11/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0039581 | L&I (01) | WA |
1003844713 | (05) | WA |
H20539 | (02) |