Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 60486426 | WA |
Y | 213EG0000X | General Practice | 60486426 | WA |
NPI | 1003223116 |
---|---|
Provider Name | Dr. Javaid Chaudhry |
First Address | Buckley, WA 98321-8509 |
Second Address | Buckley, WA 98321-8509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2014 |
Last Update Date | 08/02/2017 |