Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | DE00010956 | WA |
N | 213EG0000X | General Practice | DE00010956 | WA |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 0438000318 | VA |
NPI | 1023208857 |
---|---|
Provider Name | Dr. Cabel Aron Mcdonald |
First Address | Longview, WA 98632-2461 |
Second Address | Longview, WA 98632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2007 |
Last Update Date | 19/11/2018 |