Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD60424819 | WA |
NPI | 1639285034 |
---|---|
Provider Name | Dr. Jon E Welch |
First Address | Bellevue, WA 98005-1718 |
Second Address | Bellevue, WA 98005-1718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 29/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
59-06067 | (05) | NC |
H98387 | (02) | NC |