Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | OP60937550 | WA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101021097 | MI |
NPI | 1114331972 |
---|---|
Provider Name | Dr. Aaron Shady |
First Address | Yakima, WA 98902-2715 |
Second Address | Yakima, WA 98902-4882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 16/08/2019 |