Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 253264 | NY |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD60542553 | WA |
NPI | 1508092610 |
---|---|
Provider Name | Dr. James Arthur Fausto JR. |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98185-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2009 |
Last Update Date | 22/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1508092610 | (05) | WA |