Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD-9970 | HI |
NPI | 1164412995 |
---|---|
Provider Name | Dr. Jeffery Greene |
First Address | Seattle, WA 98112-5226 |
Second Address | Seattle, WA 98112-5226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 07/04/2021 |