Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 60480701 | WA |
NPI | 1831351360 |
---|---|
Provider Name | Dr. Jeffrey John Houlton |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 14/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1831351360 | (05) | WA |