Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD60931365 | WA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD60931365 | WA |
NPI | 1023245644 |
---|---|
Provider Name | Dr. Kim Richards Driftmier |
First Address | Fairbanks, AK 99709-3554 |
Second Address | Seattle, WA 98109-5122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2009 |
Last Update Date | 08/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023245644 | (05) | WA |