Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD60552600 | WA |
N | 208600000X | Surgeon | MD60552600 | WA |
Y | 208C00000X | Colorectal Surgeon | MD60552600 | WA |
NPI | 1013116003 |
---|---|
Provider Name | Dr. Dara Heisler Christante |
First Address | Spokane, WA 99210-2242 |
Second Address | Spokane, WA 99201-2217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2007 |
Last Update Date | 30/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0340968 | LABOR & INDUSTRIES (01) | WA |
2045502 | (05) | WA |