Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 208D00000X | WA |
NPI | 1003888256 |
---|---|
Provider Name | Desislava Zlatanova Hite |
First Address | Tacoma, WA 98415-0215 |
Second Address | Tacoma, WA 98405-4234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 11/02/2013 |