Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH00002640 | WA |
NPI | 1245281385 |
---|---|
Provider Name | Dr. Dennis Lee Banker |
First Address | Wenatchee, WA 98801-7519 |
Second Address | Wenatchee, WA 98801-6622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35756 | STATE L&I NUMBER (01) | WA |
T67409 | (02) | WA |