Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OP60546029 | WA |
Y | 207Q00000X | Family Doctor | OP60546029 | WA |
NPI | 1639432537 |
---|---|
Provider Name | Dr. David M. Escobar |
First Address | Mount Vernon, WA 98274-4127 |
Second Address | Stanwood, WA 98292 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2012 |
Last Update Date | 23/06/2016 |