Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD60414696 | WA |
N | 207PE0004X | Emergency Medical Services | N2523 | TX |
NPI | 1114161692 |
---|---|
Provider Name | Dr. Keith Saxton Gates |
First Address | Gig Harbor, WA 98335-5638 |
Second Address | Gig Harbor, WA 98335-5638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2009 |
Last Update Date | 19/05/2015 |