Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 34007976C | OH |
Y | 207RG0300X | Geriatric Medicine | OP 60343920 | WA |
NPI | 1164494605 |
---|---|
Provider Name | Dr. Maureen Ann Watson |
First Address | Yakima, WA 98902-2473 |
Second Address | Yakima, WA 98902-2473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 30/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2026194 | (05) | WA |
D38522 | (02) |