Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 60366324 | WA |
N | 208200000X | Surgeon | 60366324 | WA |
N | 208600000X | Surgeon | 60366324 | WA |
NPI | 1316014574 |
---|---|
Provider Name | Dr. Lena Sibulesky |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 09/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1316014574 | (05) | WA |