Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 059823 | GA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD 00048196 | WA |
NPI | 1235316712 |
---|---|
Provider Name | Dr. James S Lin |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98122-4379 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2008 |
Last Update Date | 24/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
194246897D | (05) | GA |