Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MD00037363 | WA |
NPI | 1194884940 |
---|---|
Provider Name | Dr. David Cassius |
First Address | Seattle, WA 98122-5395 |
Second Address | Seattle, WA 98122-5395 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2006 |
Last Update Date | 14/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G11193 | (02) | WA |