Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD00026103 | WA |
NPI | 1033486402 |
---|---|
Provider Name | Dr. Richard J. Cavell |
First Address | Camano Island, WA 98282-8787 |
Second Address | Camano Island, WA 98282-8787 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2011 |
Last Update Date | 29/11/2011 |