Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | MD00035154 | WA |
Y | 208D00000X | General Practice Physician | MD00035154 | WA |
NPI | 1033552823 |
---|---|
Provider Name | Dr. Carol Collins |
First Address | Seattle, WA 98195-7610 |
Second Address | Seattle, WA 98195-7610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2013 |
Last Update Date | 10/04/2013 |