Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1268 | WA |
NPI | 1073731915 |
---|---|
Provider Name | Dr. David S Maxwell |
First Address | Seattle, WA 98121-3036 |
Second Address | Seattle, WA 98121-3036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T01717 | (02) | WA |