Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD00032108 | WA |
NPI | 1003883679 |
---|---|
Provider Name | Dr. Amy Z Belko |
First Address | Olympia, WA 98506 |
Second Address | Olympia, WA 98506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 05/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8159394 | (05) | WA |
F89368 | (02) | WA |