Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD60776447 | WA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD60776447 | WA |
NPI | 1174783427 |
---|---|
Provider Name | Dr. Aeumuro Gashaw Lake |
First Address | Bellevue, WA 98015-0150 |
Second Address | Seattle, WA 98122-4328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 29/12/2020 |