Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD00026169 | WA |
NPI | 1164508792 |
---|---|
Provider Name | Dr. Deborah J Ayars |
First Address | Tacoma, WA 98405-1801 |
Second Address | Tacoma, WA 98405-1801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1087329 | (05) | WA |
EV6110 | REGENCE BLUESHIELD (01) | WA |
F77687 | (02) | WA |