Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 2489 | WA |
NPI | 1164457123 |
---|---|
Provider Name | Dr. Lincoln Kamell |
First Address | Seattle, WA 98107-3419 |
Second Address | Seattle, WA 98102-3143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U11469 | (02) | WA |