Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | MD00039792 | WA |
Y | 207RP1001X | Pulmonary Disease | MD00039792 | WA |
NPI | 1063450179 |
---|---|
Provider Name | Dr. Anne Marie Manicone |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 01/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063451079 | (05) | WA |
8860300 | MEDICARE PIN (01) | WA |
H85637 | (02) |