Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 60329943 | WA |
N | 208200000X | Surgeon | 43357 | MT |
N | 208600000X | Surgeon | 43357 | MT |
Y | 208200000X | Surgeon | 60329943 | WA |
Y | 208600000X | Surgeon | 60329943 | WA |
N | 2086X0206X | Surgical Oncologist | 60329943 | WA |
NPI | 1588848428 |
---|---|
Provider Name | Dr. Juan C. Mejia |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane, WA 99204-2302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2007 |
Last Update Date | 18/06/2021 |