Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | MD00020104 | WA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD00020104 | WA |
NPI | 1710062492 |
---|---|
Provider Name | Dr. Nicholas B Vedder |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98105-6008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 21/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0232124 | L&I (01) | WA |
1710062492 | (05) | WA |
A06347 | (02) |