Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101239287 | VA |
N | 208600000X | Surgeon | 0101239287 | VA |
Y | 2086X0206X | Surgical Oncologist | MD60021446 | WA |
NPI | 1316912215 |
---|---|
Provider Name | Dr. Gregory J Lavalle |
First Address | Spokane, WA 99220-3649 |
Second Address | Spokane, WA 99204-2966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 13/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8523292 | (05) | WA |
D92079 | (02) |