Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | MD00031352 | WA |
NPI | 1033181771 |
---|---|
Provider Name | Dr. Joshua Mitchell Lieberman |
First Address | Seattle, WA 98115-5851 |
Second Address | Seattle, WA 98115-5851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 08/07/2007 |