Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | AP60963397 | WA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP60963397 | WA |
NPI | 1417434572 |
---|---|
Provider Name | Dr. Joshua Snavely |
First Address | Tacoma, WA 98405-4930 |
Second Address | Tacoma, WA 98405-4930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2018 |
Last Update Date | 18/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2137316 | (05) | WA |