Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | OR DP00303 | OR |
N | 213ES0131X | Foot Surgery | WA PO00000651 | WA |
NPI | 1275644585 |
---|---|
Provider Name | David Wayne Griffin |
First Address | Vancouver, WA 98684-5887 |
Second Address | Vancouver, WA 98684-5887 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 10/07/2007 |