Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DE6025651 | WA |
NPI | 1083879266 |
---|---|
Provider Name | Dr. Bradley F. Weinstein |
First Address | Seattle, WA 98102-5882 |
Second Address | Seattle, WA 98101-1720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2008 |
Last Update Date | 13/10/2013 |