Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 15576 | WA |
NPI | 1003849373 |
---|---|
Provider Name | Dr. Allen Charles Alleman |
First Address | Federal Way, WA 98003-8705 |
Second Address | Federal Way, WA 98003-8705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 24/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1228808 | (05) | WA |
42502 | L&I (01) | WA |
A03964 | (02) | WA |