Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD20143 | OR |
NPI | 1013921402 |
---|---|
Provider Name | Dr. Patricia N Pancoast |
First Address | Seattle, WA 98124-5147 |
Second Address | Portland, OR 97205-3536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 29/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050066027 | RR MEDICARE (01) | OR |
081737 | (05) | OR |
1013921402 | (05) | ID |
8194961 | (05) | WA |
F78952 | (02) |