Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | RR60958429 | WA |
NPI | 1588281570 |
---|---|
Provider Name | Dr. Ashley Simone Simpson |
First Address | Tacoma, WA 98418-2627 |
Second Address | Gig Harbor, WA 98332-8300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2020 |
Last Update Date | 25/06/2020 |