Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 054384 | NY |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 61526 | CA |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DE60745807 | WA |
NPI | 1013174168 |
---|---|
Provider Name | Dr. Philip Werner Kaiser |
First Address | Tacoma, WA 98422-2056 |
Second Address | Puyallup, WA 98375-9604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2008 |
Last Update Date | 26/04/2017 |