Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 05637 | WA |
NPI | 1073690160 |
---|---|
Provider Name | Dr. David Reid Atherton |
First Address | Redmond, WA 98052 |
Second Address | Redmond, WA 98052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5007513 | DSHS NUMBER (01) | WA |