Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD60489943 | WA |
NPI | 1083863005 |
---|---|
Provider Name | David Keisho Su |
First Address | Seattle, WA 98195 |
Second Address | Seattle, WA 98121-2720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2008 |
Last Update Date | 19/03/2021 |