Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD00044866 | WA |
N | 207XS0117X | Orthopaedic Spine Surgeon | MD00044866 | WA |
NPI | 1407825292 |
---|---|
Provider Name | Dr. Alexis Falicov |
First Address | Seattle, WA 98104-1172 |
Second Address | Seattle, WA 98122-4319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 23/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2022072 | (05) | WA |
I35889 | (02) | WA |