Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DE00009457 | WA |
Y | 213EG0000X | General Practice | DE00009457 | WA |
NPI | 1003020215 |
---|---|
Provider Name | Dr. Rosemary Elaine Engle |
First Address | Shelton, WA 98584-7742 |
Second Address | Olympia, WA 98513-9105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |