Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | ML60466563 | WA |
Y | 2081S0010X | Sports Medicine | MD60675880 | WA |
Y | 213ES0000X | Sports Medicine | MD60675880 | WA |
NPI | 1336587385 |
---|---|
Provider Name | Dr. Erek W Latzka |
First Address | Seattle, WA 98195-4060 |
Second Address | Seattle, WA 98195-4060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 26/08/2019 |