Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD00027295 | WA |
NPI | 1023078524 |
---|---|
Provider Name | Dr. Jay Michael Watt |
First Address | Seattle, WA 98104-1172 |
Second Address | Seattle, WA 98103-6907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 10/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E68984 | (02) | WA |