Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH00003547 | WA |
NPI | 1316012776 |
---|---|
Provider Name | Dr. Brian Joseph Stemp |
First Address | Tacoma, WA 98467-3299 |
Second Address | Tacoma, WA 98467-3299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 27/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U69171 | (02) | WA |