Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | CH00003054 | WA |
N | 111NI0900X | Internist | CH00003054 | WA |
N | 111NN0400X | Neurology | CH00003054 | WA |
N | 111NN1001X | Nutrition | CH00003054 | WA |
N | 111NR0400X | Rehabilitation Chiropractor | CH00003054 | WA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | CH00003054 | WA |
NPI | 1770643991 |
---|---|
Provider Name | Dr. John Wade Hill |
First Address | Yelm, WA 98597-7530 |
Second Address | Eatonville, WA 98328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U57238 | (02) | WA |