Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 00031111 | WA |
NPI | 1235182411 |
---|---|
Provider Name | Dr. Brigit Victoria Brock |
First Address | Seattle, WA 98104-3586 |
Second Address | Seattle, WA 98104-3586 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8199010 | (05) | WA |
G42862 | (02) | WA |