Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD00021103 | WA |
NPI | 1013917913 |
---|---|
Provider Name | Donald Scott Redman |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane, WA 99202-2139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 18/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023563 | (05) | WA |
A15231 | (02) |