Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 3731 | SC |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP60854090 | WA |
NPI | 1003061722 |
---|---|
Provider Name | Dawn Ewing Galvez |
First Address | Port Orchard, WA 98366-3709 |
Second Address | Port Orchard, WA 98366-3709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2008 |
Last Update Date | 03/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2111619 | (05) | WA |