Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD60654914 | WA |
N | 111NI0900X | Internist | MD60654914 | WA |
Y | 207RH0000X | Hematologist | MD185872 | OR |
NPI | 1124361472 |
---|---|
Provider Name | Dr. Molly M Daughety |
First Address | Portland, OR 97239-3011 |
Second Address | Vancouver, WA 98664-1913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2013 |
Last Update Date | 17/03/2018 |