Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 60289820 | WA |
NPI | 1023357845 |
---|---|
Provider Name | Dr. Samuel Everett George |
First Address | Seattle, WA 98124-1703 |
Second Address | Vancouver, WA 98683 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2013 |
Last Update Date | 23/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38944 | (02) | TX |