Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | MD00026787 | WA |
N | 2080P0203X | Pediatric Critical Care Doctor | MD00026787 | WA |
NPI | 1215987342 |
---|---|
Provider Name | Dr. Daniel P Brutocao |
First Address | Seattle, WA 98124-5601 |
Second Address | Spokane, WA 99204-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8138018 | (05) | WA |
8284317 | (05) | WA |
F25370 | (02) | WA |