Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist | OS60491305 | WA |
NPI | 1649777418 |
---|---|
Provider Name | Dimitrios Gregory Sankey |
First Address | Seattle, WA 98125-7471 |
Second Address | Seattle, WA 98125-7471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2018 |
Last Update Date | 09/04/2018 |